Mesenteric venous thrombosis in two women taking oral contraceptives

Oral contraceptive-induced mesenteric venous thrombosis with resultant intestinal ischemia

The author reports a case of oral contraceptive-induced mesenteric venous thrombosis with resultant intestinal ischemia in a young woman. The relationship between mesenteric venous thrombosis and oral contraceptives is discussed. Twenty-six other cases of oral contraceptive-related mesenteric venous thrombosis reported in the English literature are reviewed.

Drug-induced gastrointestinal disease

The gastrointestinal tract is a common target for adverse drug reactions. The resultant changes are often nonspecific (e.g., mucosal ulceration, intestinal infarction, motility disturbance) and in many cases no radiographically detectable lesion may occur. A comprehensive review of the reported drug-induced disorders of the digestive organs is herein presented and their radiographic manifestations are described.

Agnogenic venous mesenteric thrombosis

One of the most difficult diagnoses to establish is that of agnogenic venous mesenteric thrombosis (AVMT). This disorder occurs chiefly in elderly patients and, unless diagnosed promptly, leads to death in most instances. AVMT may follow surgical operations or occur during a prolonged illness. In the past five years at St. Clare's Hospital and Health Center in New York City, this diagnosis was established in five patients. In reviewing these cases, it was noted that some of the signs and symptoms such as those due to hypotension and shock with marked leukocytosis, were out of proportion to those usually observed when the preoperative diagnosis is being considered. The pathologic and radiologic characteristics of this disorder are outlined, and the recommended operative procedure for treatment is discussed. The importance is stressed of prompt, vigorous and prolonged anticoagulation therapy in order to minimize the chance of recurrence in the early postoperative period. Anticoagulant therapy is also effective preoperatively, if the disease is diagnosed sufficiently early. As greater numbers of elderly patients are being treated in hospitals, this dire complication should be uppermost in the minds of physicians and surgeons if a fatal outcome is to be avoided following a successful operative procedure.

Mesenteric venous thrombosis associated with oral contraceptives: a case report

Small-bowel infarction resulting from mesenteric venous thrombosis is a rare but life-threatening complication to which young women taking oral contraceptives are liable. The patient characteristically presents with an "acute abdomen" after a variable prodromal period of vague abdominal pain. The correct diagnosis can be made from the macroscopic appearance at laparotomy, provided the surgeon is alert to the condition. An accurate diagnosis is important, as anticoagulation measures must be instituted early to counter the commonly associated thromboembolic phenomena.