Pelvic vein thrombosis as a cause of acute pelvic pain.

BACKGROUND

Pelvic vein thrombosis may occur in nonpuerperal patients with hypercoagulable conditions and have significant sequelae. The purpose of this report is to describe a nonpuerperal woman with factor V Leiden mutation who developed acute pelvic pain secondary to pelvic varix thrombosis.

CASE: A multiparous woman, status post-bilateral tubal interruption, presented with acute onset of severe left-sided pelvic pain 5-6 weeks from the onset of her last menstrual period. A pelvic computed tomography scan showed left pelvic varix thrombosis. Hematologic studies were consistent with heterozygous factor V Leiden mutation. The patient was treated with heparin and warfarin, and had complete resolution of her pain.

CONCLUSION

Pelvic vein thrombosis may cause acute pelvic pain in nonpuerperal women, especially those with primary hypercoagulopathies. This should be included in the differential diagnosis of acute pelvic pain in reproductive-age women.