RESUMO
Ovarian vein thrombosis (OVT) is a rare but serious complication, most commonly occurring in the postpartum period. This article reports the case of a 40-year-old woman who presented 12 days after a normal vaginal delivery with fever and pelvic pain. An initial diagnosis of endometritis was made, and empiric antibiotic therapy was administered, but the fever persisted. An ultrasound scan was then done to rule out appendicitis, which revealed a thrombosis of the right ovarian vein extended to the inferior vena cava. Appropriate anticoagulant therapy was immediately started with spectacular clinical improvement. Ovarian vein thrombosis is difficult to diagnose as the signs are nonspecific, like fever and pelvic pain; radiological exploration, typically doppler ultrasound and computerized tomography, are therefore required. Early treatment is crucial to prevent severe complications, especially pulmonary embolism. This case emphasizes the need for heightened clinical awareness and a multidisciplinary approach to achieve optimal outcomes in managing ovarian vein thrombosis.
RESUMO
Congenital vaginal atresia is a rare congenital abnormality of the female reproductive tract due to a failure of canalisation in the urogenital sinus. We report the uncommon case of a 14-year-old girl with a primary amenorrhea associated to a cyclical pelvic pain, in whom examination objectified a vaginal cup that replaced the introitus. Ultrasound examination and magnetic resonance imaging (MRI) revealed atresia of the lower third of the vagina. The diagnosis of partial vaginal aplasia on functional uterus was retained, the patient had a perineal vaginoplasty. The evolution was satisfactory with regular cycles and improvement of pelvic pain. The decline is three years. Congenital vaginal atresia is a rare malformation classically and clinically pictured as a primary amenorrhea with chronic cyclic pelvic pain. Diagnosis is based on clinical examination and imaging. The MRI is designed to assess the importance of atresia and guide surgical management while the surgical technique aims to restore the integrity of the utero-vaginal tract and to increase the possibility of pregnancy for these patients.