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Ovarian Vein 血栓 (Postpartum) Imaging
Ovarian Vein 血栓 (Postpartum) Imagingの画像・臨床意思決定の枠組み。ガイドラインと施設プロトコルを優先。
根拠：POVT imaging。各ノードはガイドラインの判断ロジックを要約したものであり、原文の転載ではありません。 医療従事者向けの参考情報であり、臨床判断の代替ではありません。日本の関連学会指針および施設プロトコルを優先してください。
ステップごとに回答すると、結論と対応の目安が表示されます。前の質問に戻ることもできます。
ステップ 1 · Suspected postpartum ovarian vein thrombosis
Postpartum fever + lower/flank abdominal pain — suspected ovarian vein thrombosis?
💡 POVT is rare but serious (Virchow's triad); 80–90% right-sided (the right ovarian vein is compressed by the enlarged dextrorotated uterus, the left has retrograde flow); usually within 10 days postpartum (2–15 days); lower/flank pain + fever + leukocytosis, a palpable cord-like mass. Easily misdiagnosed: appendicitis/pyelonephritis/adnexal torsion/TOA/endometritis/septic pelvic thrombophlebitis.
パス全体像
- 【判断】Suspected postpartum ovarian vein thrombosisPostpartum fever + lower/flank abdominal pain — suspected ovarian vein thrombosis?（POVT is rare but serious (Virchow's triad); 80–90% right-sided (the right ovarian vein is compressed by the enlarged dextrorotated uterus, the left has retrograde flow); usually within 10 days postpartum (2–15 days); lower/flank pain + fever + leukocytosis, a palpable cord-like mass. Easily misdiagnosed: appendicitis/pyelonephritis/adnexal torsion/TOA/endometritis/septic pelvic thrombophlebitis.）
- Contrast CT shows an enlarged ovarian vein, intraluminal filling defect + peripheral enhancement (extending to the IVC/renal vein) → Contrast CT confirmed → anticoagulation + antibiotics
- Ultrasound limited by bowel gas, uncertain → Ultrasound uncertain → contrast CT
- 【終点】Ultrasound uncertain → contrast CTOvarian Vein 血栓 (Postpartum) Imagingの当該分岐。適応・禁忌を確認し、最新ガイドラインと施設プロトコルに沿って実施。必要時専門医に相談。
- 【終点】Contrast CT confirmed → anticoagulation + antibioticsContrast CT confirmed (enlarged ovarian vein, central low-density thrombus + peripheral ring enhancement, extending cranially from the adnexaへthe renal vein/IVC, surrounding inflammatory stranding): 抗凝固 (LMWH/heparin → oral) + broad-spectrum IV 抗菌薬 (often 〜あり septic thrombophlebitis); thrombus extending into/floatingでthe IVC, complicating PE,または抗凝固 禁忌 → IVC filter; assessに対しpulmonary 塞栓 (~13%).
よくある質問
- Ovarian Vein 血栓 (Postpartum) Imagingはどの臨床課題を扱う診療パスですか？
- Ovarian Vein 血栓 (Postpartum) Imagingの画像・臨床意思決定の枠組み。ガイドラインと施設プロトコルを優先。
- Ovarian Vein 血栓 (Postpartum) Imagingの主要な意思決定ステップは何ですか？
- Suspected postpartum ovarian vein thrombosis
- Ovarian Vein 血栓 (Postpartum) Imagingはどのような対応方針を示しますか？
- Ultrasound uncertain → contrast CT：Ovarian Vein 血栓 (Postpartum) Imagingの当該分岐。適応・禁忌を確認し、最新ガイドラインと施設プロトコルに沿って実施。必要時専門医に相談。；Contrast CT confirmed → anticoagulation + antibiotics：Contrast CT confirmed (enlarged ovarian vein, central low-density thrombus + peripheral ring enhancement, extending cranially from the adnexaへthe renal vein/IVC, surrounding inflammatory stranding): 抗凝固 (LMWH/heparin → oral) + broad-spectrum IV 抗菌薬 (often 〜あり septic thrombophlebitis); thrombus extending into/floatingでthe IVC, complicating PE,または抗凝固 禁忌 → IVC filter; assessに対しpulmonary 塞栓 (~13%).
- Ovarian Vein 血栓 (Postpartum) Imagingのうち直ちに対応が必要な状況はどれですか？
- Contrast CT confirmed → anticoagulation + antibiotics：Contrast CT confirmed (enlarged ovarian vein, central low-density thrombus + peripheral ring enhancement, extending cranially from the adnexaへthe renal vein/IVC, surrounding inflammatory stranding): 抗凝固 (LMWH/heparin → oral) + broad-spectrum IV 抗菌薬 (often 〜あり septic thrombophlebitis); thrombus extending into/floatingでthe IVC, complicating PE,または抗凝固 禁忌 → IVC filter; assessに対しpulmonary 塞栓 (~13%).
- Ovarian Vein 血栓 (Postpartum) Imagingはどのガイドラインに基づいていますか？
- Postpartum ovarian vein thrombosis imaging and management (contrast CT preferred) · 準拠：POVT imaging
出典
- Postpartum ovarian vein thrombosis imaging and management (contrast CT preferred)