Inferior vena cava stenosis and Budd--Chiari syndrome in a woman taking oral contraceptives.

A young white woman who had been taking oral contraceptives for 8 yr presented with the Budd--Chiari syndrome. Stenosis of the hepatic segment of her inferior vena cava was observed and surgical correction was attempted, but she died of intravascular coagulation during the procedure. Postmortem examination showed myxoid intimal proliferation involving the hepatic, portal and femoral veins, and the inferior vena cava at the level of the stenosis. The literature describing inferior vena caval lesions causing the Budd--Chiari syndrome is reviewed, and the possible role of contraceptive steroids in the present patient is discussed.