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Mesenteric vascular occlusion associated with oral contraceptive use.

We report a case of mesenteric venous occlusion in a young woman receiving oral contraceptive medication. Review of the literature revealed this to be a rarely reported association. Discussion of the pathophysiology, diagnosis, and treatment of this entity is presented. A brief review of the literature is included.

Adult↗

[Results of therapy of acute mesenteric vascular occlusion].

From 1979 to 1984 39 patients were operated on for acute mesenteric ischemia. The purpose of this retrospective study was the documentation of the therapeutic results and discussion of the value of a second-look operation and postoperative angiography. Proximal occlusion of SMA in 33 patients (85%) resulted in extended bowel infarction, whereas segmental infarction due to peripheral occlusion was found in 15%. The hospital mortality was 85%. Operative procedure consisted of revascularisation (18%), bowel resection (18%), revascularisation and resection (10%) and explorative laparotomy (18%). The second-look operation as a routine procedure has been replaced by a postoperative angiogram. Laparotomy was performed in case of reocclusion of SMA or clinical signs.

Aged↗

PRIMARY MACROGLOBULINEMIA: DEATH DUE TO MESENTERIC VASCULAR OCCLUSION WITH GAS IN THE PORTAL VENOUS SYSTEM.

Clinical features presented by a patient with primary macroglobulinemia over a four-year period included cachexia, weight loss, bleeding tendency, anemia, lymphadenopathy, hepatosplenomegaly and recurrent pulmonary bacterial infections. Immunoelectrophoresis demonstrated the presence of a beta(2) macroglobulin which, on ultracentrifugation, was found to have a sedimentation constant of 14.9 S(20), w; this macroglobulin constituted over 40% of the total serum protein. Postmortem findings included the typical "naked" lymphocyte infiltration of the reticuloendothelial system, with septic embolization from a terminal Gram-negative bacteremia, associated with a mesenteric vascular occlusion. A feature of particular interest was the antemortem appearance of gas in the portal venous system, shown on two abdominal scout radiographs taken one and two hours before death. The diagnostic significance of this rare radiologic sign is discussed.

Blood Protein Electrophoresis↗