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E1995. Incidental Gonadal Vein Thrombosis in Computed Tomography
Authors
  1. Shaza Alsharif; King Abdulaziz Medical City; King Saud bin Abdulaziz University for Health Sciences
  2. Ahmad Subahi; King Saud bin Abdulaziz University for Health Sciences
  3. Bader Shirah; King Saud bin Abdulaziz University for Health Sciences
  4. Khalid Alshamrani; King Saud bin Abdulaziz University for Health Sciences
  5. Turki Alhazmi; King Abdulaziz Medical City; Umm Alqura University
  6. Benoit Mesurolle; Pôle Santé République
Objective:
Gonadal vein thrombosis (GVT) is an exceedingly uncommon but serious condition that can be fatal if went unnoticed and complicated by thrombophlebitis and sepsis. In this study, we aim to determine the 17-year experience of a single tertiary hospital with the incidence of GVT in CT scans. We further describe GVT associated risk factors.

Materials and Methods:
A retrospective single-center observational study. The study was approved by the Institutional Review Board. Data collection was done through the Radiology Information System (RIS) by searching for patients with the diagnosis of incidental GVT in contrast-enhanced CT of the abdomen and pelvis between January 2005 and December 2017. The Hospital Information System and Picture Archiving and Communication System were used to collect demographic profile, clinical characteristics, radiological features, and treatment parameters. All adults-patients (>14-years) with incidental finding of GVT. Patients with incomplete data were excluded. Data were collected on a database-computerized Microsoft Excel. All numerical values obtained from each item of the data-collection-sheet as well as the demographic data were computed and presented by simple descriptive statistical tests, frequency, and percentage. The Statistical Package for Social Sciences (SPSS) version 21.0 was used for data analysis. The significance level was predetermined at a significance level of 0.05 for all tests.

Results:
Total of 58-patients developed GVT and were diagnosed using contrast-enhanced CT during the study period from overall 68,268-studies with incidence of 0.8%. Fifty-seven patients were females and one male. The mean age of the patients was 49.98±15.02years. Thirty-four patients (58.6%) had right GVT while 20-patients (34.5%) had left GVT. Only 4-patients (6.9%) had bilateral GVT. The mean diameter of the thrombosed vein was 10.09±3.56mm. Twenty-nine patients (50%) had acute-thrombus while the other 50% had chronic-thrombus at the time of imaging. All patients with bilateral GVT had chronic thrombi. Nineteen patients (32.8%) had a thrombosis of another vein with the most common veins being the renal and inferior vena cava. Seven patients (12.1%) had an evidence of pulmonary-embolism. Nineteen patients (32.8%) had an evidence of a previous pelvic-surgery. Forty-four patients (75.9%) had a malignancy at the time of diagnosis. The most common sites affected were breast (9-patients) and colon (8-patients). Forty-two patients (72.4%) were treated with anticoagulants after the diagnosis of GVT while 16-patients (27.6%) were not treated due to death prior to the initiation of treatment, patient-refusal, or patient-preference to be treated at another hospital.

Conclusion:
This study showed the incidence of GVT in contrast-enhanced CT and described its associated risk factors. GVT is a rare clinical entity with vague clinical presentation. Contrast-enhanced CT is the study of choice for diagnosis, and initiation of anticoagulation is important to treat this condition and limit complications.