Abstract
BACKGROUND: Ovarian vein thrombosis (OVT) is a rare condition that most commonly affects postpartum women. It is particularly prevalent in the first 10 days postpartum, a period when women are more prone to developing this condition. The right ovarian vein is often affected due to its tortuous nature and less competent valves. OVT presents similarly to acute abdominal conditions, such as acute appendicitis, especially when the right ovarian vein is involved. Given the overlap in clinical presentation, diagnosis requires high-quality imaging techniques and a high degree of suspicion. CASE SUMMARY: Herein, we report a rare case of OVT in a young postpartum female who presented to the emergency department with signs and symptoms of acute abdomen. The patient had a history of pulmonary tuberculosis treatment. A provisional diagnosis of a perforated appendix was made, and a lower midline exploratory laparotomy was planned. During surgery, the appendix and intestines appeared normal, but a distended and thrombosed right ovarian vein was found. The affected ovarian vein was excised, and the patient was placed on anticoagulants postoperatively. The recovery was unremarkable, and anticoagulants were continued for six months. CONCLUSION: OVT is most commonly seen in the early postpartum period, especially within the first 10 days. Due to its anatomical characteristics, the right ovarian vein is more commonly involved. The clinical presentation of OVT can closely mimic acute abdomen or acute appendicitis, making diagnosis challenging. Accurate diagnosis requires a high index of suspicion and advanced imaging techniques to differentiate OVT from other conditions with similar presentations.