Микобактериальные заболевания
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POVT-Postpartum ovarian vein thrombosis as a cause of acute abdomen

Alnazeer Yousif Mohamed Abdelbagi

Ovarian vein thrombosis (OVT) is a likely severe complication correlated with conditions such as pelvic inflammatory disease, malignancy, and recent surgery. It is also associated with pregnancy. A 28-year-old female presented to the casualty complaining of right iliac fossa pain for 1 day before admission (4 days post-delivery of her second child) associated with slight fever, anorexia, and single episode of vomiting. On further questioning, she denied any preceding periumbilical pain. On clinical abdominal examination, there was tenderness on deep palpation to the right iliac fossa with positive rebound tenderness and guarding. Further investigations showed HB 12 g/dl, WBCS 14,000, Platelets 340,000, Urea 37mmol/L, Creatinine 0.7mg/dL, Na 135 mmol/, K 3.3 mmol/L. Shortly, the patient’s conditions started to deteriorate and she was moved to the theatre for emergent operative exploration. Intraoperatively, there were oedema and ischemic changes in the right fallopian tube and the right ovary. A huge, hard longitudinal retroperitoneal mass was found arising from the uterus overlying the right psoas muscle extending upward, the overlying peritoneum was dissected. Thrombosed ovarian vessels (artery & vein) were excised together with the necrotic right ovary and right fallopian tube after taking consent from the family. One week later, the patient showed a dramatic recovery. In conclusion, right side iliac fossa pain especially in the pu-erperal period should not be considered mainly as appendiceal diseases, other diseases should be in considered especially right side ovarin vessels thrombosis.