Acute intestinal ischaemia from a portal vein thrombosis in a young female smoker on an oral contraceptive

John Hunninghake, Brian Patrick Murray, David Ferraro*, John Gancayco

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

We report the case of a 23-year-old woman who presented with bloody diarrhoea and multiple syncopal events. While the initial diagnosis clinically appeared to be inflammatory bowel disease, she was found to have a portal vein thrombosis (PVT) on MR cholangiopancreatography and acute intestinal ischaemia on colonic biopsy. The aetiology of this patient's PVT is attributed to her acquired prothrombotic state from an estrogen-containing contraceptive pill in conjunction with regular tobacco use. Extensive mesenteric venous thrombosis from an acute PVT has been shown to cause intestinal ischaemia, likely from venous obstruction and reflexive arterial constriction; however, the diagnosis is often delayed until surgery or autopsy. Our case report highlights this patient's clinical presentation, workup and treatment, as part of a review for the risk factors and guidelines recommendations for management of an acute PVT.

Original languageEnglish
Article number225135
JournalBMJ Case Reports
Volume2018
DOIs
StatePublished - 2018
Externally publishedYes

Keywords

  • haematology (incl blood transfusion)
  • pancreas and biliary tract

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