Presentation
It may present as two distinct clinical syndromes: acute ovarian vein thrombosis and diffuse thrombosis of multiple small pelvic vessels. Accurate diagnosis is hampered by the absence of a reliable, specific, and noninvasive test for the disorder. [ncbi.nlm.nih.gov]
We describe an unusual case of ovarian vein thrombosis presenting as back pain in a postmenopausal woman. [ijcasereportsandimages.com]
A 50-year-old woman presented as an outpatient for follow-up imaging after completing chemotherapy and radiation for rectal adenocarcinoma. [jaocr.org]
Two of those cases were discovered incidentally. 3 Presentation OVT most commonly presents with an acute onset of abdominal or flank pain. [acepnow.com]
Case presentation A 22-year-old pregnant woman at term presented to hospital with uterine contractions, abdominal pain, nausea and vomiting. After delivery an ovarian vein thrombosis was diagnosed. [jmedicalcasereports.biomedcentral.com]
Entire Body System
- Fever
A diagnostic dilemma of fever and back pain postpartum. Chest. 2001;120:1023-1024. Back To Top [appliedradiology.com]
Septic pelvis thrombophlembitis is a cause of post-operative fever from untreated postpartum endometritis. [en.wikipedia.org]
Subsequent contrast-enhanced computed tomography scan in a postpartum patient with fever and bilateral ovarian vein thrombosis. [emedicine.medscape.com]
We report a case of postpartum ovarian vein thrombophlebitis (POVT) presenting as fever and right loin pain. [najms.org]
Physical exam findings may reveal fever, tachycardia, abdominal tenderness, and signs of peritonitis, all of which are nonspecific for this condition. [acepnow.com]
- Malaise
Importantly, many patients will have nonspecific symptoms, including malaise, vague diffuse abdominal pain, or shortness of breath. In rare cases, a mass may be palpable, but this is an unusual finding [ 11, 12 ]. [panafrican-med-journal.com]
Gastrointestinal
- Abdominal Pain
The cases are from the United States in 2012 where a 67-year- old woman was presented with a one-month history of left sided abdominal pain and from Australia in 2010 where a 42-year-old woman was presented with acute abdominal pain and nausea. [5] [6 [ijcasereportsandimages.com]
It can occur with lower quadrant abdominal pain, especially in the setting of recent pregnancy, abdominal surgery, pelvic inflammatory disease, or malignancy. [panafrican-med-journal.com]
The abdominal pain is variable in presentation and may also involve the flank or back. [appliedradiology.com]
Isolated ovarian vein thrombosis is an important, although rare, etiology of abdominal and pelvic pain. [jaocr.org]
A small rectus abdomini hematoma was revealed on abdominal and transvaginal ultrasound scans. A CT scan was requested to assess the late-postoperative abdominal pain. [jmedicalcasereports.biomedcentral.com]
Cardiovascular
- Tachycardia
Clinical signs include: fever pain on palpation of uterus midline lower abdominal pain malodorous lochia (vaginal discharge) tachycardia Laboratory results [ edit ] Septic pelvic thrombophlebitis will have elevated CRP and WBC (evidence of inflammation [en.wikipedia.org]
Physical exam findings may reveal fever, tachycardia, abdominal tenderness, and signs of peritonitis, all of which are nonspecific for this condition. [acepnow.com]
[…] bloating and tenderness (most patients do not want to be touched in the abdomen); * a tender, sausage-shaped mass near the umbilicus (present in 50 to 70% of patients); * decreased or absent bowel sounds; * nausea; * vomiting; and * increased pulse rate (tachycardia [prep4usmle.com]
Although tachycardia is common with fever and a pulse of greater than 90 beats/min qualifies as one of the criteria for sepsis. [glowm.com]
Fetal tachycardia (170 bpm) with a non-reactive pattern was detected. A fetal Doppler sonography revealed a 'brain-sparing' effect with a cerebroplacental ratio of 0.75 (normal > 1) [ 1 ]. An urgent cesarean delivery was performed. [jmedicalcasereports.biomedcentral.com]
Urogenital
- Pelvic Pain
There are many symptoms that are indicative of a pelvic / abdominal vein obstruction. A pelvic vein obstruction can cause unexplained leg pain or swelling, pelvic pain, or leg ulcers which are difficult to heal. [tennesseeveincare.com]
There are many different causes of chronic pelvic pain. This can make diagnosis difficult. Pelvic congestion syndrome (PCS) must be considered if the pain worsens when sitting or standing and is relieved with lying down. [vein.stonybrookmedicine.edu]
Pelvic / abdominal vein obstruction This causes unexplained pain in the legs and swelling, pelvic pain or leg ulcers that are difficult to heal. The leg pain worsens with exercise because of the increased flow of blood in the legs with exercise. [varicosevascular.com]
Isolated ovarian vein thrombosis is an important, although rare, etiology of abdominal and pelvic pain. [jaocr.org]
A presentation is usually with acute pelvic pain in the postpartum period, then termed puerperal ovarian vein thrombosis or postpartum ovarian vein thrombosis. [radiopaedia.org]
Workup
Many patients are asymptomatic and others may be diagnosed incidentally during coelioscopy or in etiology workup of pulmonary embolism [6], [12]. [najms.org]
The diagnostic workup of a patient with suspected TSS starts with a complete physical examination to investigate signs of multiorgan involvement. A pelvic examination is performed, which includes the removal of a tampon if one is present. [glowm.com]
Treatment
Once other conditions are ruled out, the ultimate diagnosis of septic pelvic vein thrombophlebitis may depend on how you respond to treatment. In the past, treatment would involve tying or cutting out the vein. This is no longer the case. [healthline.com]
Treatment of pelvic vein thrombophlebitis requires administration of broad spectrum antibiotics, intravenous heparin, and, in selected cases, ovarian vein and vena cava ligation. [ncbi.nlm.nih.gov]
For the treatment of VTE, rivaroxaban is given orally at 15 mg twice a day for the initial 21 days of treatment, followed by once daily at 20 mg per day for long-term treatment. [clevelandclinicmeded.com]
For treatment, you might take anticoagulants for at least 3 months. [northshore.org]
Prognosis
Abstract Background: Thrombotic events are common in cancer patients and have been associated with an adverse prognosis in large registry-based studies. [nature.com]
[…] the ovarian vein may not be identified in every case 14. tubular/serpiginous hypoechoic structure in the adnexa adjacent to the ovarian artery if the ovarian vein is identifiable, the absence of Doppler flow can be a diagnostic feature Treatment and prognosis [radiopaedia.org]
What are the symptoms, treatment, and prognosis for phlebitis? Pain, swelling, redness, and tenderness are some common symptoms of phlebitis. [medicinenet.com]
Thrombosis of the iliofemoral veins carries a worse prognosis with increased incidence of late clinical complications such as post-thrombotic syndrome [ 15 ]. [patient.info]
Phlebitis Prognosis Superficial phlebitis is rarely serious and usually responds to pain control, elevation, and warm compresses. [emedicinehealth.com]
Etiology
Clearly, the emergency physician will be on the lookout for the more common etiologies mentioned above. In this case, the emergency physician was appropriately suspicious for acute appendicitis. [acepnow.com]
Isolated ovarian vein thrombosis is an important, although rare, etiology of abdominal and pelvic pain. [jaocr.org]
This has been attributed to the dextrorotation of the uterus during pregnancy compressing that vein, but also to the increased length of the right ovarian vein and the presence of incompetent valves. [1] The etiology is thought to be due to Virchow’s [ijcasereportsandimages.com]
Ovarian vein thrombosis: analysis of patient age, etiology, and side of involvement. Del Med J 2013; 85(2): 45–50. Basili G, Romano N, Bimbi M, Lorenzetti L, Pietrasanta D, Goletti O. Postpartum ovarian vein thrombosis. JSLS 2011; 15(2): 268–71. [vestnik.szd.si]
Many patients are asymptomatic and others may be diagnosed incidentally during coelioscopy or in etiology workup of pulmonary embolism [6], [12]. [najms.org]
Epidemiology
Epidemiology DVT has an annual incidence of about 1 in 1,000 people [ 3 ]. [patient.info]
Pathophysiology
The pathophysiology of SPT is outlined by Virchow's triad: Venous stasis Injury to the vascular epithelium A hypercoagulable state These factors explain why SPT is almost always a puerperal event that is most commonly diagnosed after postcesarean endomyometritis [glowm.com]
The pathophysiology of POVT is related to the Virchow triad: the veinous stasis and hypercoagulability that commonly accompany the puerperium with superimposed injury to the vein wall usually caused by uterine infection [3], [6]. [najms.org]
Prevention
How can deep vein thrombosis be prevented? There are things you can do to prevent DVT. After surgery, you can take an anticoagulant medicine to prevent blood clots. You might also wear compression stockings. [northshore.org]
The good news is that DVT is preventable and treatable if discovered early. [cdc.gov]
Take antibiotics as a preventive measure before and after any surgeries, including a cesarean delivery. Make sure to stretch your legs and move around after your cesarean delivery. [healthline.com]
How can you prevent phlebitis? Simple measures can be taken to prevent phlebitis, although, sometimes it cannot be avoided. [medicinenet.com]