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Case of ischemic colitis in a young adolescent associated with triphasic hormonal contraceptive therapy: a case report and review of the literature.
MedLine Citation:
PMID:  22034806     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
There has been speculation that third generation hormonal contraceptives may be less prone to inducing clotting than the earlier generation products. We present a case of colonic ischemia in a young adolescent receiving pharmacotherapy with a third-generation hormonal contraceptive. Ischemic colitis is an uncommon adverse effect in young adolescents associated with hormonal contraception, especially the third generation agents. We believe this case to be the second-youngest patient reported with ischemic colitis due to this therapy. Clinical vigilance is recommended for women presenting with abdominal pain, with or without hematochezia, who are receiving hormonal contraceptive therapy. Since their introduction in the early 1960's, the combination hormonal contraceptives have been utilized by millions of women for both contraceptive and non-contraceptive purposes. Although a variety of adverse effects can be experienced by individuals taking these agents, it has been demonstrated that these agents are associated with an increased risk of venous and arterial thromboses. Publications more consistently report on the cardiovascular-, pulmonary-, peripheral vascular-, or cerebrovascular-based thrombotic events associated with these agents. During the past several decades changes have been incorporated in the dose and types of compounds included in the combination hormonal contraceptive products in an attempt to reduce the risk of coagulation and other adverse effects. Less common and less frequently publicized are the gastrointestinal-based thrombotic events that result in ischemia and presents as severe abdominal pain, with or without hematochezia. We report an uncommon case of reversible colonic ischemia in who we believe to be the second-youngest adolescent female reported in the literature (youngest aged 16 years) to have this diagnosis associated with the use of a newer, third-generation oral combination hormonal contraceptive (Naranjo scale of 7; Probable).
Authors:
D Kade Rasmussen; Larry W Segars
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The West Virginia medical journal     Volume:  107     ISSN:  0043-3284     ISO Abbreviation:  W V Med J     Publication Date:    2011 Sep-Oct
Date Detail:
Created Date:  2011-10-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0413777     Medline TA:  W V Med J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  22-5     Citation Subset:  IM    
Affiliation:
Ohio Valley Medical Center, Wheeling, USA.
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