Acute left ovarian vein thrombosis following percutaneous renal biopsy: A case report

Ovarian vein thrombosis is a previously unreported complication of percutaneous renal biopsy. We present the case of a 42-year-old female with systemic lupus erythematosus who developed acute left ovarian vein thrombosis three days after ultrasound-guided left renal biopsy performed to evaluate new-onset proteinuria. The patient presented to the emergency department with lower abdominal pain, generalized weakness, fatigue, and heart palpitations. Computed tomography with intravenous contrast revealed an anatomic variant left ovarian vein posterolateral to the left kidney with acute thrombosis. The pathogenesis is attributed to endothelial injury of the ovarian vein during the biopsy procedure and increased risk of thrombosis due to lupus-associated hypercoagulability. After exclusion of hemorrhagic and other common post-biopsy complications, the patient was managed with a three-month course of apixaban following vascular surgery consultation and was discharged in stable condition. This case underscores the importance of preprocedural vascular mapping to identify anatomical variants that may alter procedural risk and predispose to thrombotic complications.