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.