Ovarian Vein Thrombosis

Ovarian vein thrombosis is being diagnosed more frequently due to increased imaging. It can be seen in postpartum women and in women with pelvic inflammatory disease, or a history of pelvic surgery. Bland or tumor thrombosis can be seen in patients with cancer.

Patients may be asymptomatic or present with vague abdominal pain. Pulmonary embolism, sepsis, or even death are dreaded and rare complications.

CT will classically show a "filling defect in a tubular structure anterior to the psoas muscle with a central round low-attenuation center and peripheral higher-attenuation rim."

Postpartum patients and women with pelvic inflammatory disease are treated with intravenous heparin and antibiotics. Patients with a history of pelvic surgery or malignancy are not generally treated unless complicated by thrombophbebitis or pulmonary embolism.

References

• Karaosmanoglu D, Karcaaltincaba M, Karcaaltincaba D, Akata D, Ozmen M. MDCT of the ovarian vein: normal anatomy and pathology. AJR Am J Roentgenol. 2009 Jan;192(1):295-9.
• Yassa NA, Ryst E. Ovarian vein thrombosis: a common incidental finding in patients who have undergone total abdominal hysterectomy and bilateral salpingo-oophorectomy with retroperitoneal lymph node dissection. AJR Am J Roentgenol. 1999 Jan;172(1):45-7.