Ovarian vein thrombosis in a polytrauma patient

BMJ Case Rep. 2015 Dec 18:2015:bcr2015213071. doi: 10.1136/bcr-2015-213071.

Abstract

A young mother presented to a major trauma centre following a road traffic collision. Her admission CT traumagram demonstrated liver and renal lacerations, spinal and pelvic fractures with no abnormalities of the ovarian veins. Her inpatient course was uncomplicated other than a sustained, isolated raised C reactive protein. CT of the abdomen 1 week after injury demonstrated stable solid organ injuries and the additional, unexpected finding of a right ovarian vein thrombosis (OVT). A pragmatic approach was taken towards the management of the OVT given the haemorrhagic risk from her traumatic injuries. A multidisciplinary, consultant-led plan was made to slowly increase enoxaparin to a therapeutic dose under close surveillance and to then switch to warfarin following an outpatient consultation with a consultant haematologist. A MR venogram was performed after 3 months of anticoagulation, and this demonstrated complete resolution of the OVT and normal appearances of the ovary.

Publication types

  • Case Reports

MeSH terms

  • Accidents, Traffic*
  • Anticoagulants / therapeutic use
  • Enoxaparin / therapeutic use
  • Female
  • Humans
  • Multiple Trauma / drug therapy
  • Multiple Trauma / etiology
  • Ovary / blood supply*
  • Ovary / injuries
  • Patient Care Team
  • Veins*
  • Venous Thrombosis / drug therapy*
  • Venous Thrombosis / etiology
  • Warfarin / therapeutic use
  • Young Adult

Substances

  • Anticoagulants
  • Enoxaparin
  • Warfarin