Coeliac axis thrombosis associated with the combined oral contraceptive pill: a rare cause of an acute abdomen

Abstract

We report a case of coeliac axis thrombosis and splenic infarction presenting in a girl of 14 years who had been on the oral contraceptive pill (OCP), Marvelon (ethinyloestradiol 30 microg plus desogestrel 150 microg, Organon, Cambridge, UK), for 3 weeks. She had no other risk factors for thrombo-embolism. Diagnosis was made with duplex Doppler ultrasound and confirmed with dynamically-enhanced comput-ed tomography and magnetic resonance angiography, thus avoiding the need for percutaneous arteriography. Though mesenteric thrombo-embolic disease is recognised in association with use of the combined OCP, it has not previously been reported to affect the coeliac axis. Paediatricians and surgeons should be aware of the risks to young girls on the OCP, and consider it in their differential diagnosis of the acute abdomen.

Splenic infarction as a complication of celiac artery thromboembolism: an unusual cause of abdominal pain

“…Serck and Cogbill [7] reported a 59-year-old female with sigmoid colon carcinoma had acute visceral ischemia originating from celiac trunk and superior mesenteric artery and, extensive visceral infarction ensued and she died. Also celiac and splenic arteries thrombus in a 14-year-old female who had received oral contraceptive agent for menorrhagia was reported by Arul et al [8]. She was well at follow-up only with anticoagulant therapy and more aggressive therapy was not sought.…”

Image Diagnosis: Splenic Infarction Associated with Oral Contraceptive Pills in a Healthy Young Woman

“…13 OCP use has also been associated with thrombosis in unusual sites. Arul et al 14 reported a case of splenic infarction secondary to celiac thrombosis in a young female on OCP. Khomand et al 15 described a case series of 9 female patients who presented with cerebral vein thrombosis and used a short course of OCP.…”

Possible cause underlying gastric necrosis and perforation: Celiac artery thrombosis

“…Kumaran et al, reported total gastric necrosis associated with celiac artery thrombosis in a patient with acute pancreatitis [14]. Arul et al reported a case of celiac axis thrombosis and splenic infarction in a 14-year-old girl using oral contraceptive pill [15]. If acute celiac artery thrombosis is suspected, emergency angiographic imaging and revascularization may be life-saving if needed.…”