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

Munna William, T. N. Yogi, Amrit Bhusal, Mudasira Habib, Amjad Ali Raza, Waqar Ahmad, Ajay Kumar Yadav, Objan Kumar Rawal, Pramod Pathik
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Abstract

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. 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. 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. 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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一名接受口服避孕药治疗的女性因门静脉血栓形成而导致肠梗阻:一份病例报告及全面综述
门静脉血栓(PVT)是一种罕见的门静脉血流受阻病症,肝硬化是常见的诱发因素。然而,该病与口服避孕药(OCP)尤其是孕激素的关系仍未得到充分探讨。本病例报告旨在加深对这一问题的认识,重点介绍一名长期服用 OCP 的女性因 PVT 引起肠梗阻的罕见病例。 一名 45 岁女性因剧烈腹痛、呕吐和便秘就诊。诊断结果显示,PVT 引起的肠梗阻在长期服用 OCP 的情况下非常罕见。通过利伐沙班等保守治疗,患者的症状有所改善,突出了早期干预的关键作用。 该病例使人们注意到,探讨 OCP 与 PVT 之间联系的文献十分有限。尽管 OCPs 享有普遍安全的声誉,但它们也可能诱发血栓形成,这就强调了提高临床认识的必要性。PVT 肠梗阻的罕见性,再加上本病例缺乏常见的风险因素,凸显了此类病例在诊断上的挑战性。 在长期服用 OCP 的患者中,PVT 引起的肠梗阻异常罕见,这强调了多学科管理的必要性。该病例为怀疑、识别和治疗非肝硬化患者的这种罕见并发症提供了重要启示,为现有有限的相关文献做出了贡献。
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