Thread by @RyanChristieMD

Wetread Case 27

Hx: abdominal pain 🙀

Can you find the dx on this non-con exam?

Feel free to answer with professionally appropriate gif responses only. No spoilers! wetread.org #WetreadCow #FOAMrad #FOAMed #radres #errad #bodyrad @ER_Rad_Hanna @RyanBPetersonMD

@ER_Rad_Hanna @RyanBPetersonMD Answer: Right ovarian vein thrombosis (possibly thrombophlebitis)

Note the dilated, hyperdense right ovarian veins. Stranding suggests phlebitis (check with labs)

@ER_Rad_Hanna @RyanBPetersonMD Blue arrow denotes the dilated, hypderdense ovarian veins.

Remember the anatomy - R gonadal vein drains into the IVC while the L gonadal vein drains into the L renal vein

More inferiorly you can see the abnormal veins surrounding the right ovary.

@ER_Rad_Hanna @RyanBPetersonMD Classic patient is ~1 wk postpartum with fever and RLQ pain. Non-OB/GYN tend to think appendicitis but this is not a rare postpartum complication so always check out the veins when you can - even on a non-contrast exam!