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Idiopathic ovarian vein thrombosis in a nonperipartum patient. BACKGROUND: Ovarian vein thrombosis is a rare diagnosis typically seen in the early peripartum period but also in other thrombophilic states such as postsurgery, pelvic inflammatory disease, malignancy, or sepsis. We describe a case of idiopathic ovarian vein thrombosis in a healthy woman far outside the peripartum window. CASE: The patient is a 29-year-old woman, gravida 3 para 2102, with no significant surgical or medical history referred for 8 months of severe left lower quadrant pain. An ultrasonogram revealed a nonocclusive left ovarian vein thrombosis. Hypercoagulable workup and all other laboratory tests were normal. The thrombus resolved within 2 months of starting oral anticoagulation therapy. CONCLUSION: This case demonstrates the importance of including idiopathic ovarian vein thrombosis in the differential diagnosis of nonperipartum females with pelvic pain.