Gonadal Vein Thrombosis

Gonadal vein thrombosis can be a cause of acute pelvic pain. It is most commonly seen in post partum females but may also present in patients after pelvic surgery, pelvic trauma, and pelvic inflammatory disease. There is a predilection for this finding on the right side as retrograde flow through the left gonadal vein prevents stasis. 

On CECT, an enlarged gonadal vein that parallels the course of the psoas muscles with an enhancing wall and an intraluminal filling defect will be seen. Perivenous inflammatory changes may be seen. The patient above is post cesarean section. A filling defect is seen in the right gonadal vein (adjacent to the IVC) consistent with thombosis.


REFERENCES
Bennett GL, Slywotzky CM, Giovanniello G. Gynecologic causes of acute pelvic pain: spectrum of CT findings. Radiographics 2002;22:785-801.