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A rare complication of contraceptives: hematoma formation and thrombosis.

A 28-year-old non-obese, non-smoking, healthy woman presented with a five-day history of acute-onset upper abdominal pain. Her medication history included the use of an oral contraceptive for several weeks. A laboratory workup showed a total bilirubin level of 1.2 mg/dL and a lipase level of 24 U/L. Computed tomography (CT) revealed a hematoma in the uncinate process of the pancreas (Picture 1), with thrombosis in the superior mesenteric vein (SMV) and portal vein (Picture 2). The results of a hypercoagulability examination were unremarkable. The patient was discharged several days later in stable condition. A follow-up CT scan obtained three months later showed total resolution of the hematoma with partial resolution of the venous thrombosis. Pancreatic hematomas are mostly associated with trauma, severe inflammation and aneurysms. Bowel ischemia, enteritis, SMV thrombosis, portal vein thrombosis and pancreatitis have been reported to be complications of oral contraceptives (1, 2). The combination of thrombosis and hematoma formation observed in this case is rare.