Oral-contraceptive related ischemic colitis in young women: A case report

Abstract

Ischemic colitis is the most common form of gastrointestinal (GI) ischemia. The mechanism of ischemic colitis is the lack of colonic blood supply, and the causes are numerous and can be divided into two groups: vascular occlusive and non-occlusive diseases. Despite being common in elderly patients, ischemic colitis is rare in the young and usually associated with some estrogenic drugs, sickle cell anemia, vasculitis, and lupus erythematosus. In Vietnam, estrogen is a rare cause of ischemic colitis. We encountered a clinical case of ischemic colitis in a young female patient taken oral contraceptives for a long time. She visited the hospital for acute abdominal pain and bloody stools. Blood tests and abdominal computed tomography were normal. Endoscopy appearance showed a “single-stripe” sign at the descending colon to the splenic flexure. The biopsy result revealed acute mucosal damage. The patient was managed conservatively with bowel rest, intravenous fluids, and empirical antibiotics. The symptoms were improved with abdominal pain relief and yellow stools after four days. Through this case report, we warn about the risk of ischemic colitis in young women taking oral contraceptives