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CASE REPORT
Ovarian vein thrombosis in a polytrauma patient
  1. Emma Toman1,2,
  2. Alastair Beaven2,3,
  3. Moji Balogun4,
  4. Keith Porter5
  1. 1Department of Neurotrauma, Surgical Reconstruction and Microbiological Research Centre, Birmingham, West Midlands, UK
  2. 2Department of Major Trauma Service, Queen Elizabeth Hospital Birmingham, Birmingham, West Midlands, UK
  3. 3Department of Major Trauma, Surgical Reconstruction and Microbiological Research Centre, Birmingham, West Midlands, UK
  4. 4Department of Radiology, Birmingham Women's Hospital, Birmingham, West Midlands, UK
  5. 5Department of Major Trauma Service, University Hospitals Birmingham, Birmingham, West Midlands, UK
  1. Correspondence to Dr Emma Toman, emma.toman{at}nhs.net

Summary

A young mother presented to a major trauma centre following a road traffic collision. Her admission 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. CT of the abdomen 1 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 multidisciplinary, 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 MR venogram was performed after 3 months of anticoagulation, and this demonstrated complete resolution of the OVT and normal appearances of the ovary.

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