Post operative pain is often the cause of many ED visits. When patients are discharged and return with postoperative abdominal pain, common etiologies include incisional pain, neuropathic pain, musculoskeletal pain from immobility, ileus, and more sinister causes including adhesive bowel obstruction, abscess formation, and anastomotic leak. We present a 62 year-old female without any hereditary thrombophilia or other prothrombotic factors who presented to the ED after a sigmoid colectomy and diverting ileostomy for perforated diverticulitis and subsequent ileostomy reversal with abdominal pain. CT discovered a left ovarian vein thrombus extending into the left renal vein. With a myriad of diagnoses, it is important to have a low threshold for imaging to rule out serious pathology and also diagnose any unusual causes that can be treated promptly to prevent organ damage and subsequent complications.
Keywords: colorectal; general surgery.