Ovarian vein thrombosis in a polytrauma patient

Abstract

A young mother presented to a Major Trauma Centre (MTC) following a road traffic collision. Her admission computed tomography (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 (CRP). CT abdomen one 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 multi-disciplinary, 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 magnetic resonance venogram was performed after 3 months of anticoagulation and this demonstrated complete resolution of the OVT and normal appearances of the ovary.