Tromboflebite pélvica séptica em puérpera: relato de caso

Abstract

Introduction: Ovarian vein thrombosis (OVT) is a rare, but potentially grave condition, occurring predominantly during postpartum period. The clinical presentation is non-specific, usually expressed as a feverish painful abdominal syndrome. Case report: A female patient, 32 years old, pregnant (P4,B4 vaginal) , term, with clinical picture of convulsion followed by cardiopulmonary arrest in the hospital of origin. Evolved to vaginal delivery after sedative drugs and puerperal bleeding entailing to hypovolemic shock, reversed after vasoactive drugs. Patient started persistent fever picture despite negative culture and use of wide-spectrum antibiotics. It was performed a computed tomography of abdomen and pelvis that highlighted thrombophlebitis of the right gonadal vein. It was started full anticoagulation with recovery of the fever after 48 hours. Conclusion: The patient presented clinical recovery right after the anticoagulation and there were no adverse effects. In the last 20 years, the introduction of computed tomography and magnetic resonance revolutionized the diagnosis of pelvic thrombophlebitis, which allowed to evaluate the diagnosis and moreover the response to the therapy with heparin. The anticoagulant management of ovarian vein thrombosis persists controversial until the current days, however when associated to antibiotics presented secure and good clinical response.