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Extensive Aortic Thrombosis and Renal Infarction in Association With an Active Flare-Up of Crohn’s Disease

Venous thromboembolism (VTE) is a recognized extraintestinal manifestation of inflammatory bowel disease (IBD), with deep venous thrombosis (DVT) and pulmonary embolism being reported as the most frequent vascular complications in IBD patients. Much less frequently, arterial thromboembolic events ma...

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Autores principales: Saad, Eltaib, Awadelkarim, Abdalaziz, Agab, Mohamed, Babkir, Akram
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elmer Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9076158/
https://www.ncbi.nlm.nih.gov/pubmed/35572474
http://dx.doi.org/10.14740/gr1504
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author Saad, Eltaib
Awadelkarim, Abdalaziz
Agab, Mohamed
Babkir, Akram
author_facet Saad, Eltaib
Awadelkarim, Abdalaziz
Agab, Mohamed
Babkir, Akram
author_sort Saad, Eltaib
collection PubMed
description Venous thromboembolism (VTE) is a recognized extraintestinal manifestation of inflammatory bowel disease (IBD), with deep venous thrombosis (DVT) and pulmonary embolism being reported as the most frequent vascular complications in IBD patients. Much less frequently, arterial thromboembolic events may also be associated with greater morbidity and mortality. Aortic mural thrombosis is a rare phenomenon described in patients with IBD that often results in serious consequences such as visceral infarction and acute ischemia of the lower extremities. We described an unusual case of a female patient with Crohn’s disease (CD) who presented with generalized abdominal pain and vomiting. Imaging showed an active flare-up of intestinal CD as well as two mural thrombi in the distal descending thoracic aorta and the abdominal aorta at the level of the left renal artery, respectively, with a left renal infarction. The mesenteric angiogram revealed a patent celiac axis and mesenteric arteries. The patient was therapeutically anticoagulated, and she underwent a right hemicolectomy for the perforated ileal disease. A comprehensive diagnostic workup for hypercoagulability and thrombophilia was negative for an underlying etiology, and the active CD flare-up was considered the main culprit triggering the aortic thrombosis in this reported patient. Our case highlighted the occurrence of aortic thrombosis in a patient with IBD and that entails careful attention. Early recognition and timely management with a multidisciplinary team is the key to improving the outcome of aortic events that coincide with the active flare-up of IBD.
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spelling pubmed-90761582022-05-12 Extensive Aortic Thrombosis and Renal Infarction in Association With an Active Flare-Up of Crohn’s Disease Saad, Eltaib Awadelkarim, Abdalaziz Agab, Mohamed Babkir, Akram Gastroenterology Res Case Report Venous thromboembolism (VTE) is a recognized extraintestinal manifestation of inflammatory bowel disease (IBD), with deep venous thrombosis (DVT) and pulmonary embolism being reported as the most frequent vascular complications in IBD patients. Much less frequently, arterial thromboembolic events may also be associated with greater morbidity and mortality. Aortic mural thrombosis is a rare phenomenon described in patients with IBD that often results in serious consequences such as visceral infarction and acute ischemia of the lower extremities. We described an unusual case of a female patient with Crohn’s disease (CD) who presented with generalized abdominal pain and vomiting. Imaging showed an active flare-up of intestinal CD as well as two mural thrombi in the distal descending thoracic aorta and the abdominal aorta at the level of the left renal artery, respectively, with a left renal infarction. The mesenteric angiogram revealed a patent celiac axis and mesenteric arteries. The patient was therapeutically anticoagulated, and she underwent a right hemicolectomy for the perforated ileal disease. A comprehensive diagnostic workup for hypercoagulability and thrombophilia was negative for an underlying etiology, and the active CD flare-up was considered the main culprit triggering the aortic thrombosis in this reported patient. Our case highlighted the occurrence of aortic thrombosis in a patient with IBD and that entails careful attention. Early recognition and timely management with a multidisciplinary team is the key to improving the outcome of aortic events that coincide with the active flare-up of IBD. Elmer Press 2022-04 2022-03-12 /pmc/articles/PMC9076158/ /pubmed/35572474 http://dx.doi.org/10.14740/gr1504 Text en Copyright 2022, Saad et al. https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution Non-Commercial 4.0 International License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Saad, Eltaib
Awadelkarim, Abdalaziz
Agab, Mohamed
Babkir, Akram
Extensive Aortic Thrombosis and Renal Infarction in Association With an Active Flare-Up of Crohn’s Disease
title Extensive Aortic Thrombosis and Renal Infarction in Association With an Active Flare-Up of Crohn’s Disease
title_full Extensive Aortic Thrombosis and Renal Infarction in Association With an Active Flare-Up of Crohn’s Disease
title_fullStr Extensive Aortic Thrombosis and Renal Infarction in Association With an Active Flare-Up of Crohn’s Disease
title_full_unstemmed Extensive Aortic Thrombosis and Renal Infarction in Association With an Active Flare-Up of Crohn’s Disease
title_short Extensive Aortic Thrombosis and Renal Infarction in Association With an Active Flare-Up of Crohn’s Disease
title_sort extensive aortic thrombosis and renal infarction in association with an active flare-up of crohn’s disease
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9076158/
https://www.ncbi.nlm.nih.gov/pubmed/35572474
http://dx.doi.org/10.14740/gr1504
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