Abstract | INTRODUCTION: MATERIALS AND METHODS: The patient, aged 52, with a case history characterized by alteration of the alvus with occasional emission of blood, and abdominal pain. She referred with metrorrhagia of about one year, and was being treated with Ethynylestradiol/ Gestodene. A CAT scan with contrast showed the signs of thrombosis in the superior mesenteric vein. The patient underwent surgical laparotomy. On opening the peritoneum we found a large tumefaction formed of conglobate iliac loops together with intense inflammation. A resection of the tumefaction was performed "en bloc". DISCUSSION: Pharmacological contraception remains in various cases as the only identified risk factor and there are reports which also censure a relationship of greater risk with increased hormonal doses and even reports of mesenteric venous thrombosis in patients taking triphasic drugs. Thus, we may state with near certainty, that a relationship between pharmacological contraceptives and mesenteric venous thrombosis exists and is probably more than a simple risk factor in contrast to that which exists for tobacco smoking and obesity. CONCLUSIONS: Before the prescription of contraceptive therapy the examination of risk factors is necessary, compiled preferably by hematochemical screening to exclude haematological and/or coagulative pathologies, and not deriding the use of non-pharmalogical methods of contraception when possible. Considering the technological advancement of instrumentation (CAT scan, angiogram), even a diagnosis aimed at a suspected clinical history; starting from less invasive screening by ultrasonographic Doppler, might induce to a rapid intervention and thereby avoid sacrificing too much intestinal tissue if it is the case.
|
Authors | Adelmo Gubitosi, Giovanni Docimo, Nicola Avenia, Roberto Ruggiero, Franceso Esposito, Emanuela Esposito, Fabrizio Foroni, Massimo Agresti |
Journal | Annali italiani di chirurgia
(Ann Ital Chir)
2011 Jan-Feb
Vol. 82
Issue 1
Pg. 69-74
ISSN: 0003-469X [Print] Italy |
PMID | 21657159
(Publication Type: Case Reports, Journal Article, Review)
|
Chemical References |
- Contraceptives, Oral, Hormonal
|
Topics |
- Contraceptives, Oral, Hormonal
(adverse effects)
- Female
- Humans
- Mesenteric Veins
- Middle Aged
- Thrombosis
(chemically induced)
|