Superior Mesenteric Vein Thrombosis Associated With Oral Contraceptive Use

Mesenteric and portal vein thrombosis, a rare complication in a patient with polycystic ovary syndrome: A case report and review of literature

“…Five additional cases of OCP-associated intestinal ischemia related to mesenteric vein thrombosis were noted in the review of more recent published data [ [11] , [12] , [13] , [14] , [15] ]. Two of these cases did respond well to conservative treatment with heparin [ 9 , 15 ], while four patients required laparotomy [ [11] , [12] , [13] , [14] ], and three required segmental bowel resections [ [11] , [12] , [13] , 15 ].…”

“…Five additional cases of OCP-associated intestinal ischemia related to mesenteric vein thrombosis were noted in the review of more recent published data [ [11] , [12] , [13] , [14] , [15] ]. Two of these cases did respond well to conservative treatment with heparin [ 9 , 15 ], while four patients required laparotomy [ [11] , [12] , [13] , [14] ], and three required segmental bowel resections [ [11] , [12] , [13] , 15 ]. In Table 1 , the majority of patients had similar presentations of abrupt onset abdominal pain, with two of them also presenting with bloody diarrhea, and were all diagnosed after 10 days and treated with antibiotics first.…”

“… Reference Age Medical history Presenting signs and symptoms Timing of AMI diagnoses Imaging findings (CT with contrast) Other sites of thrombosis Treatment Risk factors Outcome Case 1 [ 11 ] 52 Metrorrhagia Epigastric pain and bloody diarrhea 10 days Distended loops of small intestine with hyperemic mucosa and SMV thrombosis PVT Surgical resection Smoking OCP 1 year Discharge Case 2 [ 12 ] 31 Knee arthroplasty and benign breast tumor excision. Left lower quadrant abdominal pain One day Dilation and thickening of the small intestine, small pelvic fluid collection and free air No Surgical resection OCP 3 month Discharge Case 3 [ 13 ] 38 No past medical history Diffuse abdominal pain vomiting Fever 14 days Showed acute venous mesenteric thrombosis NO intravenous heparin, Surgical resection Smoking Obese OCP 4 month Discharge Case 4 [ 14 ] 16 No past medical history Lower abdominal pain and hematochezia 11 days Computed tomogram showed a distal small bowel obstruction, thickening of the terminal ileum, and a small pelvic fluid collection No Laparotomy OCP Discharge Case 5 [ 15 ] 24 No past medical history Epigastric pain NR Results revealed a thrombosed superior mesenteric vein and peripheral branches with retroperitoneal fat stranding about the vessel, which was compatible with thrombophlebitis No Placed on a heparin drip Family history of DVT OCP Discharge ...…”