Mesenteric venous thrombosis in two women taking oral contraceptives

Ellis, David L.; Heifetz, Carl J.

doi:10.1016/0002-9610(73)90154-2

Cited by 14 publications

(5 citation statements)

References 10 publications

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“…Half the cases described had been on the pill for 6 months or less or had changed to a different preparation during this time, and she falls into such a category. A long prodromal period of mild complaints, especially abdominal pain, was noted in this patient and in four other documented cases[8,10,11,13] and perhaps it is significant that they showed histological evidence of organisation and recanalisation of thrombus. The white cell count was unusual in being normal.…”

Section: Discussionsupporting

confidence: 61%

“…Vascular disorders of the bowel rarely occur in the young adult, and mesenteric vein thrombosis is exceedingly rare occurring commonly in the middle-aged, the elderly and the diabetic and predominantly in the male [4]. There have been 13 documented reports [5][6][7][8][9][10][11] of superior mesenteric vein thrombosis attributable to oral contraceptives ('the pill') resulting in five deaths, and four cases of mesenteric arterial thrombosis associated with the pill affecting the superior mesenteric artery [12,13] and coeliac artery[l4] with three fatalities. There have also been a few reports of reversible mesenteric ischaemia presenting as ischaemic colitis, none of which required resection [7 ,15,16].…”

Section: Introductionmentioning

confidence: 99%

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The Pill, Mesenteric Vein Thrombosis and the Short, Short Bowel Syndrome

D’Sa

1980

Int J Clinical Practice

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Section: Discussionsupporting

confidence: 61%

Section: Introductionmentioning

confidence: 99%

The Pill, Mesenteric Vein Thrombosis and the Short, Short Bowel Syndrome

D’Sa

1980

Int J Clinical Practice

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“…Typically such patients present with severe abdominal pain and symptoms and signs of intestinal obstruction (Rose 1972), but in cases which are diagnosed late pcritonism may also be present. In some patients these features are accompanied by the passage of red stools (Ellis & Heifetz 1973). There is often a leukocytosis in excess of 20 x 10 6/1 and plain radiography reveals fluid levels.…”

Section: Anticholinergics and Autonomic Ganglion Blockersmentioning

confidence: 99%

Drugs Causing Intestinal Obstruction: A Review

George

1980

J R Soc Med

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Drug-induced intestinal obstruction is uncommon but nevertheless important since failure to recognize anticoagulant ileus, for example, can lead to an unnecessary operation which carries an increased risk of mortality. In addition, a wider knowledge of these problems could, if coupled with appropriate action, reduce the incidence of intestinal obstruction. The drug-induced causes of this condition are listed in Table I according to their likely site of bowel involvement. Table 1. Drugscausing intestinal obstruction Within the lumen Within the wall Outside the wall Barium sulphate Cholestyramine Potassium salts Anticoagulants Drugs affecting smooth muscle (antihistamines, opiates, c1onidine) Drugs interfering with parasympathetic nerve transmission (autonomic ganglion blockers, muscarinic antagonists (tricyclic antidepressants» Drugs causing mesenteric vascular occlusion (contraceptive pill, adrenal corticosteroids) p-adrenoceptor antagonists (practolol) Irradiation (thorium, 198 Au) Obstruction from within the lumen Bariumsulphate The occurrence of intestinal obstruction following radiographic studies with barium sulphate has' been reviewed by Ansell (1975). Since this is not strictly drug-induced it will not be considered further. Cholestyramine This resin has recently been reported to cause intestinal obstruction in infants treated with it for obstructive jaundice (Lloyd Still 1977, Poley 1978). Potassium strictures The increasing use of diuretics, and the hypokalaemia which follows with all except spironolactone, amiloride and triamterene, has led to the widespread use of potassium supplements. Although they may be necessary in patients with heart failure who are on digitalis and diuretics concurrently, their USe in other situations is less clearly established (British Medical Journal 1977). Indeed, there is increasing evidence that for many patients their routine use is unnecessary and carries a risk of hyperkalaemia (Lawson 1974). In addition, it is well documented that potassium salts in high concentration can cause spasm of vascular smooth muscle (venous and arterial) and ischaemic ulceration of the intestinal mucosa. Subsequently, there may be haemorrhage from this site and occasionally perforation

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“…Agnogenic venous mesenteric thrombosis (AVMT) is a clinicopathologic process which has definitive characteristics that separate it from venous mesenteric thrombosis (VMT), e.g., as seen in women taking oral contraceptives (11–14), or secondary to trauma, local infection, hernia, volvulus, malignant neoplasm (15), or concomitant arterial disease. It should also be distinguished etiologically from retrograde thrombosis secondary to portal hypertension in cirrhotic patients, which ultimately extends into the mesenteric veins, as described by Ottinger et al (16).…”

Section: Discussionmentioning

confidence: 99%

Agnogenic Venous Mesenteric Thrombosis†

Mitty

Purisima

1977

J American Geriatrics Society

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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.

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Mesenteric venous thrombosis in two women taking oral contraceptives

Cited by 14 publications

References 10 publications

The Pill, Mesenteric Vein Thrombosis and the Short, Short Bowel Syndrome

The Pill, Mesenteric Vein Thrombosis and the Short, Short Bowel Syndrome

Drugs Causing Intestinal Obstruction: A Review

Agnogenic Venous Mesenteric Thrombosis†

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