Oral contraceptive and acute intestinal ischemia with mesenteric venous thrombosis: a case report

Background: Venous thrombosis is a serious complication of combined contraceptive. However, mesenteric venous thrombosis and intestinal necrosis are infrequently seen in women using oral contraceptives and diagnosis is often delayed. Case presentation: We report a case of a 38-year-old obese female patient who presented with acute abdominal pain. A bowel infection was first diagnosed and treated with antibiotics. Contrast-enhanced tomography of the abdomen revealed diffuse ischemia of small intestine with superior mesenteric thrombosis. Laparotomy with segmental resection of both small and large bowel was performed. No predisposing factor of mesenteric venous thrombosis was demonstrated except association of combined contraceptive with obesity. Conclusion: This report highlights the need for clinicians to suspect venous mesenteric thrombosis in women of reproductive age with acute abdominal pain with poor physical findings. Detailed personal history including prescriptions should help to quickly and accurately determine the problem