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Left Ovarian Vein Thrombosis Presenting as Acute Postpartum Pyelonephritis
Ovarian Vein Thrombosis (OVT) is an extremely rare and uncommon thrombotic condition commonly attributed to the postpartum period. We report a case of a 30 yr old P2002 who presented with one day history of fever, chills, vomiting, abdominal and left flank pain. Patient had a preterm vaginal birth a...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Cureus
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7053676/ https://www.ncbi.nlm.nih.gov/pubmed/32181089 http://dx.doi.org/10.7759/cureus.6854 |
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author | Azhar, Erum Nguyen, Truongson Waheed, Abdul |
author_facet | Azhar, Erum Nguyen, Truongson Waheed, Abdul |
author_sort | Azhar, Erum |
collection | PubMed |
description | Ovarian Vein Thrombosis (OVT) is an extremely rare and uncommon thrombotic condition commonly attributed to the postpartum period. We report a case of a 30 yr old P2002 who presented with one day history of fever, chills, vomiting, abdominal and left flank pain. Patient had a preterm vaginal birth at 34 weeks gestation, four days prior to her presentation. Patient was febrile on presentation with left CVA tenderness and diffuse abdominal tenderness. Pelvic Ultrasound showed enlarged uterus 14.7cm x 10.9cm x 8.5cm consistent with a postpartum uterus, with heterogeneous endometrium 2.3 cm, no retained products and normal adnexa. CT scan with contrast showed fluid along the anterior aspect of the left anterior kidney, left psoas muscle and extending down to the left side of the uterus and extending to the region of the left renal vein which confirmed left ovarian thrombosis. A CT Chest with contrast and bilateral lower extremity Doppler ruled out pulmonary embolism and deep vein thrombosis, respectively.The patient was admitted, treated with antibiotics and therapeutic dose of low molecular weight heparin (Enoxaparin) and responded well. Patient was discharged home on oral apixaban. The clinical presentation of OVT is non-specific and can be similar to that of acute pyelonephritis. Physicians should have a high index of suspicion in postpartum patients presenting with flank pain and imaging techniques such as MRI, CT scan and ultrasound should be used to help in making the diagnosis. |
format | Online Article Text |
id | pubmed-7053676 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-70536762020-03-16 Left Ovarian Vein Thrombosis Presenting as Acute Postpartum Pyelonephritis Azhar, Erum Nguyen, Truongson Waheed, Abdul Cureus Emergency Medicine Ovarian Vein Thrombosis (OVT) is an extremely rare and uncommon thrombotic condition commonly attributed to the postpartum period. We report a case of a 30 yr old P2002 who presented with one day history of fever, chills, vomiting, abdominal and left flank pain. Patient had a preterm vaginal birth at 34 weeks gestation, four days prior to her presentation. Patient was febrile on presentation with left CVA tenderness and diffuse abdominal tenderness. Pelvic Ultrasound showed enlarged uterus 14.7cm x 10.9cm x 8.5cm consistent with a postpartum uterus, with heterogeneous endometrium 2.3 cm, no retained products and normal adnexa. CT scan with contrast showed fluid along the anterior aspect of the left anterior kidney, left psoas muscle and extending down to the left side of the uterus and extending to the region of the left renal vein which confirmed left ovarian thrombosis. A CT Chest with contrast and bilateral lower extremity Doppler ruled out pulmonary embolism and deep vein thrombosis, respectively.The patient was admitted, treated with antibiotics and therapeutic dose of low molecular weight heparin (Enoxaparin) and responded well. Patient was discharged home on oral apixaban. The clinical presentation of OVT is non-specific and can be similar to that of acute pyelonephritis. Physicians should have a high index of suspicion in postpartum patients presenting with flank pain and imaging techniques such as MRI, CT scan and ultrasound should be used to help in making the diagnosis. Cureus 2020-02-03 /pmc/articles/PMC7053676/ /pubmed/32181089 http://dx.doi.org/10.7759/cureus.6854 Text en Copyright © 2020, Azhar et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Emergency Medicine Azhar, Erum Nguyen, Truongson Waheed, Abdul Left Ovarian Vein Thrombosis Presenting as Acute Postpartum Pyelonephritis |
title | Left Ovarian Vein Thrombosis Presenting as Acute Postpartum Pyelonephritis |
title_full | Left Ovarian Vein Thrombosis Presenting as Acute Postpartum Pyelonephritis |
title_fullStr | Left Ovarian Vein Thrombosis Presenting as Acute Postpartum Pyelonephritis |
title_full_unstemmed | Left Ovarian Vein Thrombosis Presenting as Acute Postpartum Pyelonephritis |
title_short | Left Ovarian Vein Thrombosis Presenting as Acute Postpartum Pyelonephritis |
title_sort | left ovarian vein thrombosis presenting as acute postpartum pyelonephritis |
topic | Emergency Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7053676/ https://www.ncbi.nlm.nih.gov/pubmed/32181089 http://dx.doi.org/10.7759/cureus.6854 |
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