Postpartum vena ovarica thrombophlebitis és acut appendicitis.

Postpartum ovarian vein thrombosis (POVT), a relatively rare but potentially life-threatening condition, most commonly affects women who have recently given birth. It is more common after cesarean section than after spontaneous delivery. Before the routine availability of modern imaging techniques, the diagnosis was based on exploratory laparotomy, whereas today, the diagnosis of POVT is based primarily on various imaging techniques. It develops in 90% of cases in the first ten days after delivery. Hormonal changes and compression of the inferior vena cava by the uterus are the basis of thrombus formation in the deep veins of the lower limbs and pelvis. In this case report, we present the case of a 40-year-old woman who, following spontaneous preterm delivery, developed diffuse abdominal complaints and fever on the first day after delivery. Her abdomen became diffusely tender to pressure, she reported pain according to the McBurney score, indirect tests were positive, and her CRP started to rise (72 mg/L at that time). An abdominal ultrasound was performed, on which no abnormality was described. The patient was referred to the Department of Surgery, where an emergency appendectomy was performed the day after delivery (histological diagnosis: acute appendicitis). Despite intravenous antibiotic treatment, her inflammatory values continued to rise (CRP: 148 mg/L, WBC: 18.5 G/L), and the patient developed a fever again. After several changes in antibiotic treatment, the patient's inflammatory laboratory values improved, but intermittent febrile episodes were observed. Thus, an imaging study was performed because of the multiple days of complaints of a distended abdomen, the patient's condition, and the results of laboratory investigations. CT scan confirmed the diagnosis of inferior vena cava and vena ovarica thrombosis. After consulting with specialists in infectology and haemostaseology therapeutic LMWH treatment was introduced. Anticoagulation and antibiotic treatment is the cornerstone of therapy. However, there are no definite guidelines for the duration of the treatment. There are no recommendations for POVT prophylaxis in the following pregnancy, and recurrence is infrequent. [ABSTRACT FROM AUTHOR]