Simultaneous occurrence of five prothrombotic induced vaso-occlusive phenomena and focal nodular hyperplasia due to prolonged use of combined oral contraceptive pills

This is a rare case of a patient simultaneously presenting with five complications associated with the prolonged (5 years) use of combined oral contraceptives. The two main ingredients of combined oral contraceptives responsible for thromboembolism are estrogen (estradiol) and progestogen (progestin). Progestins are linked with occlusion of arteries while estrogens can induce both arterial and venous thrombosis. This case represents a patient with portal vein thrombosis, superior mesenteric vein thrombosis, coeliac artery occlusion, splenic and jejunal infarction and focal nodular hyperplasia.