1Eui Yong Jeon

1Sheikh Khalifa Specialty Hospital

Introduction(s):

Isolated mesenteric and portal vein thrombosis is caused in various conditions and oral contraceptive and clomiphene induced thrombosis is very rare. The thrombotic event became more common in COVID-19 pandemic period, and we found 2 cases related to COVID-19 infection and vaccination and medication of oral contraceptive and clomiphene. We want to present the cases with follow up result after medical treatment.

Material(s) and Method(s):

Two young patients (43 years old) without underlying disease of hypertension and diabetes presented to emergency department due to upper abdominal pain and diagnosed as having isolated mesenteric and portal vein thrombosis on abdominal CT examination. Medication history was searched with workups for systemic hypercoagulability. Follow up radiologic studies were done more than 3 months in both patients.

Result(s):

Isolated mesenteric and portal vein thrombosis were found in both patients, without evidence of mesenteric hypertension, such as ascites and bowel wall thickening on initial CT. Close workups for systemic hypercoagulability revealed negative results, other than medication of oral contraceptive in female (COVID-19 positive) and clomiphene in male (COVID-19 vaccinations 5 months before) patients. Follow up CT and ultrasonography studies revealed chronic thrombotic occlusion of mesenteric and portal veins, with cavernous transformation of portal veins.

Conclusion(s):

Hypercoagulability in COVID-19 infection can increase the prevalence of isolated mesenteric and portal vein thrombosis in patients taking medication of oral contraceptive and clomiphene. Chronic thrombotic change with obliteration of portal vein implicates more active treatment other than anticoagulation therapy in COVID-19 pandemic period.