PB1392 - Ovarian vein thrombosis case series at King Fahad Medical City in Riyadh, Saudi Arabia

Background: Ovarian vein thrombosis (OVT) is uncommon, occurring with a variable frequency of 1/600 to 1/2000 pregnancies. It is associated with different conditions, including thrombophilia, malignancy, sepsis, intraabdominal and pelvic inflammatory conditions, pregnancy, postnatal period, and specific surgical interventions, particularly gynecological surgeries.

Aims: To identify the potential risk factors for ovarian venous thrombosis and elaborate on the standard treatment strategies in its management.

Methods: Our study consists of 18 patients diagnosed with ovarian vein thrombosis (OVT) between 2005 and 2016; the data were collected from the Health Information Management system at King Fahad Medical City (KFMC) in Riyadh, Saudi Arabia using a standard format. The diagnosis was made via one of the following clinical tools: Doppler ultrasonography, computed tomography (CT) scan, or magnetic resonance imaging (MRI).

Results: Our study found that OVT involved the right ovarian vein more often than the left and mainly occurs in women during their postnatal period. These patients' other risk factors included hypertension, diabetes, and a high body mass index (BMI). The most common presenting complaints were abdominal pain and fever. The most common treatment was the administration of enoxaparin (low molecular weight heparin) for an average duration of one to three months, which was associated with a low recurrence rate of OVT.

Conclusion(s): Physicians should be vigilant and have a low threshold for suspicion of OVT in female patients presenting with lower abdominal pain and fever in their postnatal period. Additionally, it is suggested to use low molecular weight heparin as initial therapy for OVT for one to three months, resulting in a high remission rate.