Surgical implications of ovarian vein thrombosis.

Ovarian vein thrombosis, with rare exceptions, is a puerperal process that often mimicks appendicitis but may be recognized only in retrospect as a source of continued pulmonary embolization. Ovarian vein thrombosis may also accompany septic pelvic thrombophlebitis and constitute a life-threatening problem. Ovarian vein thrombosis probably exists in a subclinical form as well, and the relative infrequency of reports of this entity attest to the lack of clinical recognition rather than to its clinical rarity. Most instances of ovarian vein thrombosis will respond to antibiotics, anticoagulation, hydration and bed rest but, when septic in etiology, interruption of the vena cava and ovarian veins may be required. Acute appendicitis, the most frequent misdiagnosis, often leads to exploration, and careful resection of the affected vein in such patients generally results in cure.