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  • Title: Portal vein thrombosis and fatal pulmonary thromboembolism associated with oral contraceptive treatment.
    Author: Capron JP, Lemay JL, Muir JF, Dupas JL, Lebrec D, Gineston JL.
    Journal: J Clin Gastroenterol; 1981 Sep; 3(3):295-8. PubMed ID: 6974749.
    Abstract:
    We report a 33-year-old woman who took oral contraceptives for 8 years, and who developed gastrointestinal bleeding from esophageal varices. Celiac and mesenteric angiography demonstrated a portal vein thrombosis. Because of several episodes of dyspnea, a pulmonary angiogram was also performed, and showed partial or complete obstruction of both inferior pulmonary arteries with "pruning" of lower lobes. Despite immediate anticoagulant therapy, the patient died suddenly some days later. We believe that oral contraceptive treatment could have induced thromboembolic disease both in portal and pulmonary circulations in this patient. This case study reports on a 33 year old woman who took oral contraceptives (OCs) for 8 years and who developed gastrointestinal bleeding from esophageal varices. This bleeding was found to be due to the results of a portal vein thrombosis. The woman had taken norgestrel and ethylnylestradiol. Abdominal pain without vomiting and diarrhea, and mild and intermittant dyspnea occurred. At laparoscopy, the volume and the surface of the liver appeared normal; biopsy of the liver was also normal. Celiac and mesenteric angiography demonstrated a portal vein thrombosis. Pulmonary thromboembolism probably occurred first during or immediately after the portal vein thrombosis. Despite immediate anticoagulant therapy, the patient died suddenly some days later. Two factors enhanced the patient's susceptibility to estrogen associated thrombosis: her age of 33 years and that she had taken the pill for over 5 years. OC treatment could have induced thromboembolic disease both in portal and pulmonary circulations in this patient.
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