Ovarian Vein Thrombosis: Diagnosis and Management of an Unusual-Site Venous Thrombosis for the Acute Physician

Ovarian vein thrombosis (OVT) is a rare and under-recognised form of venous thromboembolism that is frequently missed due to absent or non-specific symptoms.Consequently, diagnosis is often delayed or made incidentally on cross-sectional imaging.Although OVT is usually associated with the postpartum period, it is increasingly recognised in patients with malignancy, pelvic surgery, and intra-abdominal infection.Potential complications may be life-threatening and include thrombus extension, pulmonary embolism, and, less commonly, sepsis and bleeding.Despite increasing recognition, evidence remains limited to small case series and reports.As such, there remains uncertainty regarding the optimal diagnostic approach and the use of anticoagulation, including indications for anticoagulation, duration of treatment, and follow-up.This review summarises the current evidence on the epidemiology, risk factors, clinical presentation, investigations, and management of OVT, and proposes a practical approach to the diagnosis and treatment of OVT for the acute physician.