Oral contraceptives and hepatic vein thrombosis

The purpose of this paper is to report on three cases of the Budd-Chiari syndrome in young women who were taking oral contraceptives. Two patients survived, with gradual resolution of hepatomegaly and ascites following discontinuance of the birth control pills. One death occurred soon after the patient's admission to the hospital. The pathophysiology of this phenomenon involves two major aspects. Oral contraceptives are known to cause a hypercoagulation state as well as a direct effect on the blood vessels. In this series the combination of hypercoagulation and progressive occlusion of the vessels in patients on oral contraceptives appeared to lead to the development of thrombosis of the liver vessels.