Postpartum ovarian vein thrombosis
A clinical case of thrombosis of the right ovarian vein in the postpartum period - an extremely rare pathology in which acute appendicitis is often suspected due to the identity of the symptoms of the diseases. Performed laparoscopy, during which a large fragment of a thrombosed vein was excised. Conclusion. Extensive right ovarian vein thrombosis with a normal hemostasiogram could not only not be resolved by anticoagulants, but also potentially spread to the renal veins and inferior vena cava, increasing the risk of pulmonary embolism. Ovarian vein thrombosis (OVT) is a well-known but extremely rare disease. It is considered that this nosology was first described in 1956 [1,2], and its frequency is 60 times lower than that of leg deep venous thrombosis. Generally, OVT is associated with the postpartum period, less often with pelvic inflammatory disease (PID), trauma, sepsis, gynecological malignancies, pelvic surgeries and hypercoagulable states. In the OVT clinic associated with pregnancy or the postpartum period, pelvic pain, fever, and sometimes nausea and vomiting are predominant. The incidence of symptomatic postpartum OVT varies between 0.01 0.05% of the total number of vaginal deliveries, reaching 2% after cesarean section. Complications of symptomatic OVT can be sepsis, as well as a thrombus floating into the inferior vena cava or left renal vein; in rare cases, pulmonary embolism has been described. Asymptomatic OVT is detected much more often: in 30% of women after vaginal delivery with screening magnetic resonance imaging and in 80% of cases in the population of nonpregnant women after severe gynecological surgeries. Due to the rare occurrence and nature of clinical symptoms (pelvic pain, fever, nausea), prehospital diagnosis of OVT is significantly difficult, and in right-sided OVT, acute appendicitis is often suspected. Of particular difficulty is the diagnosis of idiopathic OVT, since