Pelvic vein thrombosis as a cause of acute pelvic pain.

BACKGROUND: Pelvic vein thrombosis may occur in nonpuerperal patients with hypercoagulable conditions and have significant sequelae. The purpose of this report is to describe a nonpuerperal woman with factor V Leiden mutation who developed acute pelvic pain secondary to pelvic varix thrombosis. CASE: A multiparous woman, status post-bilateral tubal interruption, presented with acute onset of severe left-sided pelvic pain 5-6 weeks from the onset of her last menstrual period. A pelvic computed tomography scan showed left pelvic varix thrombosis. Hematologic studies were consistent with heterozygous factor V Leiden mutation. The patient was treated with heparin and warfarin, and had complete resolution of her pain.
CONCLUSION: Pelvic vein thrombosis may cause acute pelvic pain in nonpuerperal women, especially those with primary hypercoagulopathies. This should be included in the differential diagnosis of acute pelvic pain in reproductive-age women.