Een kraamvrouw met pijn rechts in de onderbuik

Background

Pain in the lower abdomen is a common complaint with an extensive differential diagnosis. After childbirth, an ovarian vein thrombosis (OVT) needs to be considered as well. This is a relatively rare condition characterized by abdominal pain with fever. However, due to the non-specific symptoms, the diagnosis is often missed.

Case description

A 26-year old woman, four days after delivery, presented with acute abdominal pain in the right lower quadrant. Blood results showed leukocytosis (10.8 x 109 mL) and an elevated CRP (138 mg/L). Ultrasound showed a tubular structure with fat infiltration, most likely due to appendicitis. Laparoscopy was performed, which revealed an appendix sana. Postoperative CT-abdomen showed an OVT, as an explanation of complaints.

Conclusion

An OVT is an uncommon thrombotic complication in childbirth. Since clinical presentation can mimic that of appendicitis, specific attention for OVT is necessary for adequate diagnosis and prompt treatment of female patients with abdominal pain after delivery.

Conflict of interest and financial support: none declared.