A Rare Case of Left-Sided Ovarian Vein Thrombosis

Ovarian vein thrombosis (OVT) is an uncommon but potentially serious postpartum complication, typically affecting the right ovarian vein. This case study provides a rare presentation of left-sided OVT in a 26-year-old woman, 1 week postpartum, which followed a vaginal birth after cesarean (VBAC). The patient presented to the emergency department with persistent left lower quadrant pain, beginning 1 day post-delivery. Laboratory findings revealed leukocytosis and anemia. Sonographic evaluation identified abnormal left adnexal findings, raising suspicion for OVT. Subsequent computed tomography (CT) confirmed thrombus within the left ovarian vein extending into the left renal vein, with associated inflammatory changes. She was admitted for treatment with anticoagulants, analgesics, and referred to hematology. This case highlighted the importance of maintaining a high index of suspicion for OVT, even in atypical presentations, such as left-sided involvement or after vaginal delivery. It underscores the diagnostic value of sonography as a frontline imaging technique and the need for further evaluation using cross-sectional imaging. Sonographers should be aware that although right-sided OVT is more common, left-sided cases can occur, particularly in patients with underlying thrombotic risk factors. Timely diagnosis and management are crucial to prevent serious complications, including thrombus propagation and embolism.