Ovarian Vein Thrombosis with Involvement of the Renal Vein After Cesarean Section A Case Report

BACKGROUND: Ovarian vein thrombosis (OVT) is a rare postpartum venous thromboembolic disease (VTED) which may involve the renal, vein and the inferior vena cava. It can cause pulmonary thromboembolism and is a potentially fatal postpartum complication. A high index of suspicion is required for the prompt diagnosis and management in cases with tow back or abdominal pain after delivery. CASE: A 32-year-old woman complained of left low back pain at 6 days after cesarean section. On physical examination she had temperature of 37.7 degrees C and, localized obvious percussion tenderness in the left renal region. Pelvic examination was unremarkable. Laboratory investigations revealed elevated white blood cell count (12,000) with neutrophilia (84.8%), urine protein 3+, and urine occult blood 3+. Computed tomography scan showed the classical radiological presentation of OVT with involvement of the renal vein. The patient was successfully managed conservatively with low-molecular-weight heparin and antibiotics. CONCLUSION: OVT with involvement of the renal vein is a very rare condition of postpartum VTED and may cause serious complications if left untreated. A high index of suspicion is required in order to diagnose this unusual cause of low back or abdominal pain and fever after delivery.