Obliterative Portal Venopathy Caused by Oral Contraceptive Pills: A Case Report

Ashraf, Muhammad Farhan; Trifonova, Radiana; Batool, Asra

doi:10.14740/jmc3779

Cited by 1 publication

(5 citation statements)

References 14 publications

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“…This phenomenon is linked to the influence of oestrogen, a possible element in combined oral contraceptive pills, which raises fibrinogen levels and certain coagulation factors like II, VII, VIII, and X. The progestin component also contributes to this mechanism, though to a lesser extent which has been reported in the present case 8 – 10 . However, the connection between oral contraceptive medications and the occurrence of PVT remains an inadequately explored area in the existing literature, with very few reported cases 3 , 8 .…”

Section: Introductionsupporting

confidence: 62%

“…The progestin component also contributes to this mechanism, though to a lesser extent which has been reported in the present case 8 – 10 . However, the connection between oral contraceptive medications and the occurrence of PVT remains an inadequately explored area in the existing literature, with very few reported cases 3 , 8 . This case report aims to contribute to the understanding of this relationship, specifically focusing on the rare presentation of PVT-induced intestinal obstruction in a female undergoing oral contraceptive therapy.…”

Section: Introductionsupporting

confidence: 57%

“…Despite being generally safe, OCPs are associated with an increased risk of coagulopathies, such as venous thromboembolism, myocardial infarction (MI), and thrombotic stroke. This risk, though more common in women over 35 who smoke, can affect any OCP user without any identifiable risk factors, as in the presented case 8 . Thrombosis risk in COCs primarily stems from the oestrogenic component, which induces a pro-thrombotic state by affecting platelets, clotting factors, and anticoagulant pathways.…”

Section: Discussionmentioning

confidence: 62%

“…Diagnosing PVT-induced intestinal obstruction in the context of prolonged oral contraceptive use is challenging due to nonspecific symptoms, atypical presentations, and limitations in imaging modalities like ultrasonography. The condition’s rarity and the potential for overlap with other abdominal issues further contribute to delays in diagnosis, emphasizing the importance of heightened clinical awareness and a comprehensive diagnostic approach 8 , 9 .…”

Section: Discussionmentioning

confidence: 99%

“…Resistance occurs in 10%, but benefits are seen in intestinal infarction. Early initiation within the first week yields a 69% recanalization rate 3 , 8 , 22 , 25 . In chronic PVT, anticoagulants, administered to 30%, prevent thrombotic events with low mortality.…”

Section: Discussionmentioning

confidence: 99%

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Intestinal obstruction induced by portal vein thrombosis in a female undergoing oral contraceptive therapy: a case report with comprehensive review

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Introduction: Portal Vein Thrombosis (PVT) is a rare medical condition that obstructs blood flow in the portal vein, with cirrhosis as a common predisposing factor. However, its association with oral contraceptive pills (OCPs) particularly with progestins remains inadequately explored. This case report aims to contribute to this understanding, focusing on the rare presentation of PVT-induced intestinal obstruction in a female on prolonged OCP therapy. Case Presentation: A 45-year-old female presented with severe abdominal pain, vomiting, and constipation. Diagnosis revealed PVT-induced intestinal obstruction, an exceptionally rare occurrence in the context of prolonged OCP therapy. The patient’s symptoms improved with conservative management, including rivaroxaban, highlighting the crucial role of early intervention. Discussion: This case brings attention to the limited literature exploring the link between OCPs and PVT. Despite the generally safe reputation of OCPs, they can induce pro-thrombotic conditions, emphasizing the need for heightened clinical awareness. The rarity of intestinal obstruction in PVT, compounded by the absence of common risk factors in this case, underscores the diagnostic challenges associated with such presentations. Conclusion: PVT-induced intestinal obstruction in a patient on prolonged OCP therapy is exceptionally rare, emphasizing the necessity for multidisciplinary management. It provides crucial insights into suspecting, identifying, and treating this uncommon complication in non-cirrhotic individuals, contributing to the limited existing literature on the subject.

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