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Ovarian Vein Thrombophlebitis Related to Large Uterine Myoma

Haynes, Meagan Campol MD, MPH; Lu, Benjamin Y. BS; Winkel, Abigail Ford MD

doi: 10.1097/AOG.0000000000000091
Case Report

BACKGROUND: Ovarian vein thrombophlebitis is commonly considered to be a postpartum or postoperative disease. We describe an unusual case of ovarian vein thrombophlebitis in a nonpuerperal patient without recent surgery that was associated with venous compression by a large uterine myoma.

CASE: A 32-year-old nulligravid woman presented with fever, leukocytosis, and severe abdominal pain. Ultrasound demonstrated an enlarged uterus measuring 16.6×7.9×9.6 cm with a dominant left exophytic myoma; computed tomography scan revealed an intraluminal thrombus in the left ovarian vein. The patient recovered with antibiotics and anticoagulation. Abdominal myomectomy was performed to remove the structural contributor for thrombosis formation.

CONCLUSION: Ovarian vein thrombophlebitis should be considered in patients with abdominal pain, fever, and evidence of venous stasis, even if they are lacking typical risk factors of pregnancy or surgery.

Ovarian vein thrombophlebitis, although classically associated with recent pregnancy or surgery, can occur in patients with structural contributors to venous stasis, including compressive uterine myomas.

Department of Obstetrics and Gynecology, New York University School of Medicine, New York, New York.

Corresponding author: Meagan Campol Haynes, MD, MPH, New York University School of Medicine, NBV 9E2, 550 First Avenue, New York, NY 10016; e-mail: Meagan.Campol@nyumc.org.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2014 by The American College of Obstetricians and Gynecologists.