Which of the following liver disorders is a complication associated with oral contraceptives?: (A) Drug-induced hepatitis with fatty change, (B) Cholangiocarcinoma, (C) Cavernous hemangiomas, (D) Intrahepatic cholestasis
Answer is D. Oral contraceptives produce an intrahepatic cholestasis that is unpredictable (not related to the dose). The incidence of liver cell adenomas is also increased as a result of oral contraceptive use. These vascular tumors have a tendency to rupture during pregnancy, paicularly those in a subcapsular location. A purpoed increase in the incidence of focal nodular hyperplasia (FNH) is associated with oral contraceptive use. Grossly, FNH is characterized by a poorly encapsulated nodule that has a lighter color than the surrounding hepatic parenchyma. On cut section, a centrally located stellate scar radiates out to the periphery of the lesion. Microscopically, the hepatocytes between the scar tissue are normal. A slightly increased risk for hepatocellular carcinoma is another effect of bih control pills on the liver. Oral contraceptives are not associated with drug-induced hepatitis with fatty change, cholangiocarcinoma, cavernous hemangiomas, or fulminant hepatic failure.