Tahiri Laura Leci, Haxhibeqiri Valdete
Faculty of Medicine, University of Prishtina "Hasan Prishtina", Prishtina, Kosovo.
Clinic of Vascular Surgery, University Clinical Center of Kosovo, Prishtina, Kosovo.
Am J Case Rep. 2025 Aug 4;26:e948398. doi: 10.12659/AJCR.948398.
BACKGROUND This report describes the case of a 51-year-old woman with a history of smoking and oral contraceptive use presenting with thrombosis of the hepatic, superior mesenteric, splenic, and left renal arteries. Oral contraceptive use is associated with an increased risk of both venous and arterial thrombosis, including visceral arterial thrombosis. This report presents a rare case of extensive visceral arterial thrombosis potentially related to the combined risk factors of long-term oral contraceptive use and long-term smoking. CASE REPORT A 51-year-old woman presented with severe abdominal pain localized to the epigastrium and left flank pain, nausea, vomiting, and fever persisting for over 24 hours. Contrast-enhanced computed tomography (CT) revealed extensive thrombosis involving the hepatic, superior mesenteric, splenic, and left renal arteries. She had a 20-year history of continuous oral contraceptive use and long-term smoking but did not have a family history or laboratory evidence of a hypercoagulable disorder. She was treated successfully with anticoagulation and supportive care despite complications from heparin-induced thrombocytopenia (HIT). CONCLUSIONS This case illustrates the increased risk of extensive visceral arterial thrombosis in women using second-generation oral contraceptives and who are long-term smokers. It emphasizes the diagnostic and therapeutic challenges in managing multifocal visceral arterial thrombosis, particularly when driven by non-genetic, modifiable risk factors. Early recognition and timely initiation of appropriate anticoagulation therapy can lead to favorable outcomes, although clinicians must remain alert to complications such as HIT during treatment.
背景 本报告描述了一名51岁女性的病例，该女性有吸烟和口服避孕药史，出现肝动脉、肠系膜上动脉、脾动脉和左肾动脉血栓形成。口服避孕药与静脉和动脉血栓形成风险增加有关，包括内脏动脉血栓形成。本报告呈现了一例罕见的广泛内脏动脉血栓形成病例，可能与长期口服避孕药和长期吸烟的联合危险因素有关。病例报告 一名51岁女性出现严重腹痛，局限于上腹部和左侧胁腹疼痛、恶心、呕吐及发热持续超过24小时。增强计算机断层扫描（CT）显示广泛血栓形成，累及肝动脉、肠系膜上动脉、脾动脉和左肾动脉。她有20年持续口服避孕药和长期吸烟史，但没有高凝状态疾病的家族史或实验室证据。尽管出现肝素诱导的血小板减少症（HIT）并发症，她经抗凝和支持治疗后成功治愈。结论 本病例说明了使用第二代口服避孕药且长期吸烟的女性发生广泛内脏动脉血栓形成的风险增加。它强调了在处理多灶性内脏动脉血栓形成时的诊断和治疗挑战，特别是由非遗传、可改变的危险因素引起时。早期识别并及时启动适当的抗凝治疗可带来良好结局，尽管临床医生在治疗期间必须警惕诸如HIT等并发症。
