Published online Jul 26, 2025. doi: 10.12998/wjcc.v13.i21.103525
Revised: March 5, 2025
Accepted: March 27, 2025
Published online: July 26, 2025
Processing time: 156 Days and 19.3 Hours
Ovarian vein thrombosis (OVT) is a rare condition that most commonly affects postpartum women. It is particularly prevalent in the first 10 days postpartum, a period when women are more prone to developing this condition. The right ovarian vein is often affected due to its tortuous nature and less competent valves. OVT presents similarly to acute abdominal conditions, such as acute appendicitis, especially when the right ovarian vein is involved. Given the overlap in clinical presentation, diagnosis requires high-quality imaging techniques and a high degree of suspicion.
Herein, we report a rare case of OVT in a young postpartum female who presented to the emergency department with signs and symptoms of acute abdomen. The patient had a history of pulmonary tuberculosis treatment. A provisional diagnosis of a perforated appendix was made, and a lower midline exploratory laparotomy was planned. During surgery, the appendix and inte
OVT is most commonly seen in the early postpartum period, especially within the first 10 days. Due to its anatomical characteristics, the right ovarian vein is more commonly involved. The clinical presentation of OVT can closely mimic acute abdomen or acute appendicitis, making diagnosis challenging. Accurate diagnosis requires a high index of suspicion and advanced imaging techniques to differentiate OVT from other conditions with similar presentations.
Core Tip: Ovarian vein thrombosis (OVT) is a rare condition most commonly seen in postpartum women, presenting with acute abdominal symptoms that can mimic more common conditions like acute appendicitis, ovarian torsion, or ectopic pregnancy. The right ovarian vein is more frequently affected due to its anatomical characteristics, and symptoms typically include right lower quadrant abdominal pain, fever, nausea, and vomiting. Accurate diagnosis requires high suspicion and imaging techniques such as ultrasound, computed tomography, or magnetic resonance imaging. In this case, surgical examination revealed a thrombosed right ovarian vein in a 35-year-old postpartum woman who had been initially diagnosed with acute appendicitis. Surgical excision of the vein, followed by anticoagulation therapy with Rivaroxaban, led to an uneventful recovery. OVT should be considered in the differential diagnosis of postpartum abdominal pain to ensure timely intervention and prevent complications. Early detection and appropriate management are key to favorable outcomes.