Ovarian vein thrombosis is a rare condition most often seen in patients who are postpartum, but it can also be seen in antepartum patients as well as those with recent gynecologic surgery, gynecologic cancer, inflammatory bowel disease, or pelvic inflammatory disease. Occurrence is thought to be between 1/600 and 1/2000 deliveries.

The etiology for this condition is unknown, although it is believed to be related to Virchow's triad of vessel wall injury, venous stasis, and hypercoagulability. It is often discovered incidentally during a work-up for a source of abdominopelvic pain.

Patients present with acute-onset abdominal or flank pain. The predominance of disease occurs on the right side due to the unique anatomy of the right ovarian vein, although disease can be on the left side or bilateral. Fever and/or elevated white blood cell count will often accompany the pain. Most commonly, the patient will be newly postpartum (within the first week or two of delivery). Some patients will present as septic secondary to an infected clot.

When an infection / sepsis occurs in the postpartum period that eventually causes thrombus formation, it is called septic pelvic thrombophlebitis. The concept / management is similar to that of an ovarian vein thrombosis. These patients may or may not appear ill; they may have only fever as their presenting symptom.