Unilobar small hepatic vein obstruction: possible role of progestogen given as oral contraceptive

The case of a 33-yr-old woman with an obstruction of small hepatic veins limited to the right lobe of the liver is reported. Abdominal pain, fever, absence of ascites, and normality of liver biochemical tests were the most striking features. Abnormalities characteristic of lesions were observed on surgical wedge liver biopsy, hepatic phlebography, and computerized tomography. None of the usual causes of small hepatic vein obstruction were found. This patient had been taking an oral progestative compound as contraceptive therapy for 7 mo before evaluation. Because progestogens have recently been incriminated in the occurrence of vascular alterations, the possible role of this drug in our case is discussed.