Volume 7 • Issue 2 • 1000295 Short Communication Open Access OMICS Journal of Radiology O M I C S J o u r n a l o f R a d i o l o g y ISSN: 2167-7964 Aidara et al., OMICS J Radiol 2018, 7:2 DOI: 10.4172/2167-7964.1000295 OMICS J Radiol, an open access journal ISSN: 2167-7964 *Corresponding author: Cherif Mohamadou Aidara, Department of Radiology, Fann University Hospital, Cheikh Anta Diop Street, BP 5035 Dakar-Fann, Senegal, Tel: 00221763110301; Email: matoouz@gmail.com Received February 28, 2018; Accepted March 24, 2018; Published March 30, 2018 Citation: Aidara CM, Diop AD, Ahmed K, Diouf AA, Diallo M, et al. (2018) Postpartum Ovarian Vein Thrombosis (POVT): A Short Focus Update. OMICS J Radiol 7: 295. doi: 10.4172/2167-7964.1000295 Copyright: © 2018 Aidara CM, et al. 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. Postpartum Ovarian Vein Thrombosis (POVT): A Short Focus Update Aidara CM 1* , Diop AD 1 , Ahmed K 2 , Diouf AA 2 , Diallo M 2 , Diop AN 1 , Diop SB 1 and Niang EH 1 1 Department of Radiology, Fann University Hospital, Cheikh Anta Diop Street, BP 5035 Dakar-Fann, Senegal 2 Department of Gynecology and Obstetrics, Pikine University Hospital, Near Military Camp of Thiaroye, Dakar, Senegal Postpartum ovarian vein thrombosis is a rare condition but claims special attention because of its potentially serious complications. It occurs 0.05% to 1.8% of vaginal deliveries and 1 to 2% of cesareans. Te right side is reached in 80 to 90% of cases [1-3]. Te ovarian vein is organized into the ovarian venous plexus that collects in a single vein. It increases in diameter signifcantly during pregnancy from 9 to 27 mm. It travels in the retroperitoneal space and joins the renal vein on the right side and the inferior vena cava on the lef side. Te proximity of the ureter explains possibility of compression in case of thrombosis [4]. In addition to thrombophilia factor during peripartum period, septic conditions must be added as an endometritis that justifes routine antibiotic therapy in this condition. However, ovarian vein thrombosis can be observed in neoplasia or infections [3]. Teh et al. reported an observation of ovarian vein thrombosis due to Campylobacter fetus bacteremia [5]. Intense low pelvic pain and fever are most ofen the complaints of patients sufering from POVT. But it may be asymptomatic or even rapidly fatal. Others diagnosis are possible such as appendicitis or intestinal infammation. Leukocytosis, elevation of CRP rate is classical. Increase rate of D-dimers is nonspecifc in this period. Search for thrombophilia factor seems useless [6]. Tis classical manifestation of intense and feverish pelvic pain requires exploration in imaging to rule out other causes of acute infammatory abdomen and avoid an unnecessary surgery [1,7,8]. Imaging (ultrasound, CT and MRI) typically shows a tortuous and latero-uterine formation, containing a thinly hypoechoic material in the ultrasound examination (Figure 1) or dense intravascular material in the CT (Figures 2 and 3). It continuous in the retro peritoneum space (Figures 1 and 2). Sometimes there is a pseudo latero-uterine mass due to thrombosis in the pampiniform plexus (Figure 1). Possible ureteral compression and hydronephrosis should be appreciated (Figure 2). CT is the most routinely examination because of its availability and accessibility. It is an essential tool in abdominal emergency imaging. CT and ultrasound have a sensitivity and specifcity up to 95% and 50% respectively. But MRI seems more specifc and should be reserved in case of doubt [7-9]. POVT is a diagnostic and therapeutic emergency. Its potential complications are essentially [9,10]: i. Pulmonary embolic migration which occurs in 13% with a mortality of about 4 to 5%, ii. Te extension of thrombosis to the inferior vena cava and renal veins. Involvement of the renal vein may be revealed by a fank pain, hematuria, proteinuria, transient renal failure, iii. Septic dissemination, iv. Ureteral compression. Treatment is mainly based on curative anticoagulation and antibiotic therapy [3 Xavier]. Tere is no consensus on the duration. Te prognosis of this condition seems good throughout the literature and related mainly to embolic pulmonary migration. In case of no response to treatment, flter placement in the lower vena cava or thrombectomy with hysterectomy is discussed on a case by case basis [7]. Confict of Interest No Figure 1: Ultrasound parasagittal pelvic section scan showing a tortuous tubular structure with a thinly hypoechoic content (triangle) and going back to the right retroperitoneum indicating thrombosis of the right ovarian vein.