OC15.03: Pelvic vein thrombosis and associated pelvic abnormalities

Venous thrombosis (VT) commonly arises from the deep veins of the lower limbs. Studies have also shown that VT can originate from “unusual sites” such as the pelvis but there is an overall paucity of data on how to diagnose and manage pelvic vein thrombosis (PVT). The aim of this study was to identify pelvic abnormalities that may be associated with increased risk of developing PVT. This was a prospective cross-sectional study of women who were referred to our clinic over a 16-month period. All women had a pelvic ultrasound scan which included a detailed examination of the uterus, ovaries and adnexa. In addition, pelvic blood vessels were examined using B-mode and Doppler ultrasound to search for signs of PVT. We compared the prevalence of pelvic abnormalities in women diagnosed with PVT with findings in a large group of women who were attending our general gynecology outpatient clinic. A total of 50 women were diagnosed with PVT during the study period. Of these, 29 women (58%) had evidence of other single or multiple pelvic abnormalities on ultrasound which have been summarised in table 1. Adenomyosis was significantly more common in women diagnosed with PVT compared to controls (Z=3.187, p0.05). These findings show that most women diagnosed with PVT had evidence of concomitant pelvic pathology on ultrasound scan. The presence of adenomyosis was associated with an increased risk of developing PVT. The mechanism by which adenomyosis causes thrombosis is unclear and it will need to be addressed in further studies.