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Which of the following liver disorders is a compli¬cation associated with oral contraceptives?

A
Drug-induced hepatitis with fatty change
B
Cholangiocarcinoma
C
Cavernous hemangiomas
D
Intrahepatic cholestasis
High-Yield Explanation
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, particu­larly those in a subcapsular location. A purported 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 birth control pills on the liver. Oral contraceptives are not associated with drug-induced hepatitis with fatty change, cholangiocarci­noma, cavernous hemangiomas, or fulminant hepatic failure.

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