Presentation
Left flank pain for two days, history of caesarean section one month ago.
Patient Data
The left renal vein appears dilated and hyperdense in the non-contrast study, showing a filling defect during venous phase imaging following intravenous contrast nearly from its origin, with few tiny collaterals and surrounding perinephric fat stranding, however, there is no obvious hypoenhancing wedge cortical areas, delayed or persistent enhancement or kidney swelling, features suggesting renal vein thrombosis.
There are marginally enhancing dilated tubular structures bilaterally arising from the expected origin of gonadal veins down to the pelvis, showing internal filling defect and surrounding fat stranding, suggesting bilateral gonadal vein thromboses.
Two adjacent rim-enhancing lesions are noted in the pelvis anterior to the urinary bladder, measuring collectively about 5 x 2 cm with surrounding fat stranding suggesting abscesses.
Pubic subcutaneous fat stranding is mostly related to the previous CS surgery.
Case Discussion
Gonadal and renal vein thromboses are one of the recognised postpartum complications.
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