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Oral contraceptive and acute intestinal ischemia with mesenteric venous thrombosis: a case report

Authors Béliard A, Verreth L, Grandjean P

Received 13 October 2016

Accepted for publication 15 November 2016

Published 27 January 2017 Volume 2017:8 Pages 9—11


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Professor Igal Wolman

Aude Béliard,1 Lucie Verreth,2 Pascale Grandjean2

1Department of Obstetrics and Gynaecology, Centre Hospitalier du Bois de l’Abbaye (CHBA), Liege, Belgium; 2Department of Obstetrics and Gynaecology, Centre Hospitalier Régional (CHR) Mons Hainaut, Mons, Belgium

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.

Keywords: hormonal contraceptive, deep venous thrombosis, superior mesenteric vein, obesity, bowel infection

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