Ischaemic colitis and the contraceptive pill.

Abstract

A case report of a woman who suffered an attack of ischemic colitis while taking Ovulen is presented. The 39 year old woman had been taking Ovulen cyclically as a contraceptive for 2 years and had been changed to Ovulen 50 2 weeks before her admission to the hospital. The clinical course and radiological features in the patient were typical of ischemic colitis. She had a sudden left-sided abdominal pain followed by bloody diarrhea which rapidly improved without specific treatment. Barium-enema examination showed changes at the typical site which progressed from narrowing with marginal thumb-printing through sacculation to complete normality. The unusual feature was the patients age and sex. The condition usually occurs in the age group at risk from degenerative vascular disease more common in men. Previously there have been case reports of young oral contraceptive users who showed radiological evidence of transient ischemic colitis. It is recommended that ischemic colitis be considered in all young women who present with acute abdominal pain and blood-stained diarrhea who are taking a contraceptive pill.