Ovarian vein thrombophlebitis as a complication of second trimester abortion

Ovarian vein thrombophlebitis (OVT) is a rare but serious complication, most often described postpartum but also possible after abortion or pelvic surgery. It represents part of a spectrum that includes ovarian vein thrombosis, OVT and septic pelvic thrombophlebitis (SPT). Clinical features are non-specific, with pelvic pain and persistent fever often mimicking endometritis, urinary tract infection or other abdominal conditions, which contributes to delayed diagnosis. Imaging, particularly contrast-enhanced CT, is crucial for confirmation. We report the case of a woman in her 20s who developed OVT after an abortion at 16 weeks’ gestation, an exceedingly uncommon setting for this condition. Diagnosis was established by clinical features, inflammatory markers and CT showing right ovarian vein thrombosis. She was successfully treated with broad-spectrum antibiotics and anticoagulation, transitioning from low-molecular-weight heparin to rivaroxaban, with complete recovery.