Unusual Case of Mesenteric Venous Thrombosis Associated With Oral Contraceptive Use in an Adolescent Girl (original) (raw)
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Oral contraceptive and acute intestinal ischemia with mesenteric venous thrombosis: a case report
Open Access Journal of Contraception, 2017
Background: Venous thrombosis is a serious complication of combined contraceptive usage. However, mesenteric venous thrombosis and intestinal necrosis are infrequently seen in women using oral contraceptives, and in such cases diagnosis is often delayed. Case presentation: We report the case of a 38-year-old obese female patient who presented with acute abdominal pain. A bowel infection was first diagnosed and treated with antibiotics. Contrast-enhanced tomography of the abdomen revealed diffuse ischemia of the small intestine with superior mesenteric thrombosis. Laparotomy with segmental resection of both small and large bowel was performed. No predisposing factor of mesenteric venous thrombosis was demonstrated except association of the combined contraceptive with obesity. Conclusion: This report highlights the need for clinicians to suspect venous mesenteric thrombosis in women of reproductive age with acute abdominal pain and poor physical findings. Detailed personal history including prescriptions should help to quickly and accurately determine the problem.
Venous thrombosis and Intestinal ischemia due to short term Oral contraceptive treatment
Oral contraceptives are widely used for birth control, treatment of dysmenorrhoeal, metromenorrhagia, endometriosis and suppression of postpartum lactation .there are several serious side effects as same as venous thrombosis, pulmonary embolism, myocardial infarction and Intestinal necrosis and perforation is a clinical and pathological presentation of the infrequently seen mesenteric venous thrombosis in women using oral contraceptives. On CT, the hallmark of mesenteric ischemia caused by SMV thrombosis is marked bowel wall thickening with sever mesenteric haziness or edema and a considerable degree of collateral vasculature in the mesentery as well as in the retroperitoneum .here We report a case of a previously healthy 23-year-old female, who presented to emergency department with a 5-day history of abdominal pain, The pain was located in the epigastria, She did not smoke or drink alcohol history. She was placed on oral contraceptive 17 days prior to presentation for ovarian cyst...
Medical Principles and Practice, 2009
Objective: We present a case of acute intestinal infarction in a pregnant woman with chronic idiopathic mesenteric vein thrombosis (MVT) under regular anticoagulation treatment. Case Presentation and Intervention: The condition of the 26-year-old woman who was diagnosed with chronic idiopathic MVT after detailed investigation was stable after receiving regular anticoagulation with warfarin. One year later, she presented with a 7-day episode of intermittent epigastric pain. Acute intestinal infarction and concomitant 7-week pregnancy were diagnosed. To preserve her life, a dilation and curettage procedure and emergency laparotomy with bowel resection were performed. Ten days later, she was discharged, having made a good recovery. Conclusion: Although pregnancy was not the primary cause of chronic MVT, it did play a role in inducing the acute intestinal infarction. This case indicates that pregnant patients with known chronic idiopathic MVT should be counseled about the high risk of acute mesenteric thrombosis. This case also serves to remind physicians that there should always be a high level of suspicion of intestinal infarction in patients with an acute abdomen who are in a hypercoagulable state.
Clinical and Applied Thrombosis-Hemostasis, 2000
We describe the thrombophilic and clinical characteristics of a group of patients who suffered venous thrombosis (VT) (n = 36) and ischemic stroke (n = 8) while taking oral contraceptives (OC). Our purpose is to ascertain whether there are differences between users of second and third generation progestogen and to investigate the influence of concurrent congenital and acquired risk factors (other than OC) on the onset of the thrombosis. The group of patients included 36 women with VT and eight with ischemic stroke. The patients' recognized predisposing factors were recorded. We also considered age, length of time on OC, types of OC, rethrombosis, family history of VT, and the presence of thrombophilic genetic defects. In the group of patients with VT, 54% were treated with second generation OC (n = 23), and 30% (n = 11) were treated with third generation OC. We found no significant statistical differences with respect to age and length of time on OC between the two types of OC. The prevalence of genetic defects in these patients—factor V (FV) Leiden, prothrombin G20210A mutation and protein S deficiency—was 19% (n = 7), 17% (n = 6), and 8% (n = 3) respectively. We observed the shortest time lapse between initiating OC and the first
Asploro Journal of Biomedical and Clinical Case Reports, 2020
Since there are millions of pill users around the world, the relationship between oral contraceptives, thrombotic events, and the cerebrovascular accident has been the focus of numerous studies. Most of the cases described in the literature are of deep venous thrombosis in the lower limbs and thromboembolism in the pulmonary artery. This article aims to report a rare case of pulmonary vein thrombosis, along with cerebrovascular accident in a young patient who uses oral contraceptives. We seek to elucidate this relationship between the use of different oral contraceptives and the risk of thrombus formation, in addition to providing a brief review of these pathological episodes in the body. In view of the scarce existence of studies with reports of pulmonary venous thrombosis, it is expected to provide information to the entire medical community.
Thrombotic diseases in young women and the influence of oral contraceptives*1
American Journal of Obstetrics and Gynecology, 1998
In the evaluation of the clinical impact of thrombotic diseases in young women, age-specific incidence rates must be calculated for both arterial and venous thrombotic diseases, but also the case-fatality rate and figures for the clinical consequences among those who survive thrombosis must be included. The aim of this analysis was to quantify the clinical impacts of both arterial and venous thrombotic diseases among young, nonpregnant women and thereafter to assess the influences of oral contraceptives on these measures. STUDY DESIGN: Nationwide register data on the morbidity and mortality of venous thromboembolism, myocardial infarction, and thrombotic stroke in Denmark, 1980-1993, and 3 ongoing case-control studies to assess the influence of oral contraceptives on the risk for development of these thrombotic diseases. RESULTS: In women 15-29 years old venous thromboembolism is about twice as common as arterial complications, whereas in women 30-44 years old the number of arterial complications exceeds that of venous diseases by about 50%. The mortality rate from arterial diseases is 3.5 times higher than that from venous diseases among women <30 years old and 8.5 times higher than that from venous diseases in women 30-44 years old. The proportion of women with a significant disability among women who had an arterial complication was about 30%; the proportion was about 5% among women with venous thromboembolism. CONCLUSION: Anticipating a differential influence on venous and arterial diseases from oral contraceptives with second-and third-generation progestogens, it was calculated that users of oral contraceptives with second-generation progestogens had 30% greater increased risk of thrombotic diseases, 260% greater increased risk of thrombotic deaths, and 220% greater increased risk of thrombotic disability than users of oral contraceptives with third-generation progestogens.
Pathophysiology of Haemostasis and Thrombosis, 2009
We present the case of a 17-year-old girl who suddenly woke up with localized pain in the left groin and the inability to twist her leg. After comprehensive physician and laboratory examinations, deep venous thrombosis with consequent pulmonary embolism was ascertained. She had not experienced any recent trauma, but she had started to take oral contraceptives 6 months prior to the onset of the symptoms. Her parents and sisters had been asymptomatic throughout their lives, but the family history revealed a few thromboembolic accidents. Using DNA analysis, heterozygosity for factor V Leiden, prothrombin gene mutation G20210A and methylenetetrahydrofolate reductase C677T, as well as the homozygous 4G/4G genotype in the plasminogen activator inhibitor 1 were identified in our patient. Subsequently, DNA analysis was performed in all living family members, and multiple factors associated with thrombophilia were discovered. Our case confirms the multifactorial cause of thromboembolic events and emphasizes the importance of oral contraceptive use in the onset of venous thrombosis, especially in teenage females. In addition, this case indicates that teenage females with a family history of thrombosis who are making choices about contraception could most likely benefit from advanced thrombophilia testing.
Venous thrombembolism, thrombophilic defects, combined oral contraception and anticoagulation
Archives of Gynecology and Obstetrics, 2009
Background Several genetic polymorphisms increase the risk for venous thrombembolism (VTE). In particular, combined oral contraceptives (COCs) are known to enhance the risk for VTE and are therefore contraindicated. Case We present here the case of a patient with protein S deWciency, who has used COCs together with anticoagulatory therapy (Phenprocoumon) after suVering from deep venous thromboses for 4 years. At the time of her Wrst consultation at our clinic, the ultrasound examination showed a complete involution of her venous thrombosis. Conclusion COCs can be used in patients with thrombogenic mutations and anticoagulatory therapy in individual cases.