Homozygous Factor V Leiden presenting as irreversible chronic colon ischemia resulting from inferior mesenteric vein thrombosis

Zheng, Kevin; Brandt, Lawrence J.; LeFrancois, Darlene

doi:10.1007/s12328-021-01440-4

Cited by 1 publication

(1 citation statement)

References 16 publications

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“…Limited cases of APS-associated severe ischaemic colitis are reported, most in association with diagnosis of catastrophic APS [ 3 , 12–14 ]. Other reported cases of hypercoagulability and microvascular thrombosis resulting in fulminant ischaemic colitis include that of coronavirus disease 2019 infection [ 7–9 ] and inherited Factor V Leiden mutation [ 10 ]. In all cases of venous and microvenular ischaemic colitis onset was slow, with a wide variation of primary symptoms and CT imaging findings.…”

Section: Discussionmentioning

confidence: 99%

Severe ischaemic colitis secondary to microvenular thrombosis in a hypercoagulable patient

Moran,

Trivedi

2024

Journal of Surgical Case Reports

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A young patient with multifactorial prothrombotic risk factors presented with signs and symptoms of ischaemic colitis, without evidence of bowel hypoperfusion on imaging. She deteriorated with trial of conservative management and required operative management. Intraoperative findings demonstrated severe, confluent large bowel necrosis, sparing the rectum. A total colectomy was performed, with return to intensive care unit due to intraoperative hemodynamic instability. A return to theatre the following day allowed for formation of ileostomy and definitive closure. Histopathological findings of microvenular thrombosis were confirmed. Venous causes of ischaemic colitis present diagnostic challenges due to variable presentation and imaging findings. Microvascular venous thrombosis is likely secondary to multifactorial prothrombotic risk factors including positive autoantibodies and variable compliance with warfarin therapy for aortic value replacement. We present this case of ischemic colitis secondary to an unusual aetiology to emphasize the need to remain clinically suspicious of severe abdominal pain despite relatively benign imaging findings.

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Section: Discussionmentioning

confidence: 99%