AN UNUSUAL CAUSE OF RIGHT-SIDED ABDOMINAL PAIN IN PUERPERIUM

Abstract

Ovarian vein thrombosis (OVT) is a rare serious condition seen mainly in postpartum women. Most of the cases occur in the right ovarian vein. Non-specific symptoms and signs oen lead to misdiagnosis. We describe a case of OVT in a 33-year-old Afro- Caribbean woman presenting on day-8 following spontaneous vaginal delivery with severe right-sided abdominal pain, marginally raised white blood cell count (WBC) and C-reactive protein (CRP). She was low risk for thromboembolism and had an uncomplicated pregnancy. Transabdominal ultrasound scan (TAUS) revealed a suspicious mass in the right lumbar region and a contrast enhanced CT scan (CECT) revealed a thrombosed right ovarian vein. High degree of suspicion and imaging are necessary to establish the diagnosis of OVT. Uterine fundal tenderness may be an important clinical finding. Anticoagulation is the cornerstone of management. Multidisciplinary approach is needed to successfully treat and to avoid complications.

Keywords:Ovarian vein thrombosis; Postpartum; Fever; Pain; Uterine tenderness; CT