Inflammatory bowel disease emergencies

Cheung, O. T.; Regueiro, Miguel

doi:10.1016/s0889-8553(03)00095-5

Cited by 31 publications

(15 citation statements)

References 61 publications

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“…14 Nine percent of thromboembolic events in IBD are found in the portal venous system, and this is associated with a mortality rate as high as 50%. 15 Cerebral vascular events, including cerebral venous thrombosis, carotid artery thromboembolism, and retinal branch artery occlusion, account for 10% of thrombotic events in IBD and are associated with high mortality and neurologic morbidity rates. 15 Thrombi affecting the pulmonary, gonadal, cardiac, and peripheral vessels have also been described.…”

Section: Discussionmentioning

confidence: 99%

“…15 Cerebral vascular events, including cerebral venous thrombosis, carotid artery thromboembolism, and retinal branch artery occlusion, account for 10% of thrombotic events in IBD and are associated with high mortality and neurologic morbidity rates. 15 Thrombi affecting the pulmonary, gonadal, cardiac, and peripheral vessels have also been described. 15 Because of the increased risk of thrombosis, thromboprophylaxis with low-molecular-weight heparin of all hospitalized patients with IBD has been suggested, although it has not yet been studied.…”

Section: Discussionmentioning

confidence: 99%

“…15 Thrombi affecting the pulmonary, gonadal, cardiac, and peripheral vessels have also been described. 15 Because of the increased risk of thrombosis, thromboprophylaxis with low-molecular-weight heparin of all hospitalized patients with IBD has been suggested, although it has not yet been studied. 16 The pathogenesis of the thrombotic complications of IBD appears to be multifactorial.…”

Section: Discussionmentioning

confidence: 99%

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Clinical Challenges: 18 Year Old Male with Bloody Diarrhea

Kim

Newman

Keljo

2005

The Journal of Pediatrics

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical Challenges: 18 Year Old Male with Bloody Diarrhea

Kim

Newman

Keljo

2005

The Journal of Pediatrics

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“…Cerebral vascular accidents are associated with 10% of thromboembolic events in IBD patients and approximately 80% of those patients develop permanent neurologic defects. 4 Arterial thromboembolic events in IBD are rarely described. 5 Multiple risk factors for thromboembolic have been identified in patients with IBD.…”

Section: To the Editormentioning

confidence: 99%

Widespread Occlusive Vascular Disease in a Crohn's Disease Patient With Profound Thrombocytosis

Wiesen¹,

Kurtz²,

Katz³

2006

Journal of Clinical Gastroenterology

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“…Causes include drugs, connective tissue diseases, diabetes mellitus and hypothyroidism (4,10,11). Intestinal pseudo-obstruction can be distinguished from toxic megacolon by the presence of systemic toxicity and histological evidence of severe inflammation of the colonic smooth muscle layer in the latter (12) . Colonic pseudo-obstruction may be associated with similar changes in the oesophagus, stomach or small intestine; hence oesophageal manometry may be a useful adjunct to diagnosis (10).…”

Section: Casementioning

confidence: 99%

Intestinal pseudo‐obstruction complicating multiple sclerosis

Lane

Pender

2005

Internal Medicine Journal

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Three patients with intestinal pseudo-obstruction secondary to multiple sclerosis are reported. This is a serious complication with significant morbidity and mortality, which is infrequently recognized in clinical practice and rarely reported in the medical literature.Keywords bowel obstruction; gastroparesis; intestinal pseudo-obstruction; multiple sclerosisIntestinal pseudo-obstruction is a rarely reported, but serious complication of multiple sclerosis that may lead to significant morbidity and mortality. It is likely to be due to interruption of neural pathways in the brainstem and spinal cord by primary demyelination and axonal loss.Case 1: A 49-year-old man had a history of multiple sclerosis of the primary progressive type for 18 years. His disease had caused severe disability with persistent diplopia, atonic bladder, requiring intermittent self-catheterization, and limitation of walking distance to 10 m with the aid of a walking frame. His comorbidities included obesity, hypercholesterolaemia, obstructive sleep apnoea (requiring continuous positive airways pressure support at night), and type 2 diabetes mellitus diagnosed 1 year previously. His current medications were: atorvastatin 20 mg daily, celecoxib 200 mg daily, amitriptyline 50 mg daily, baclofen 25 mg t.d.s and omeprazole 20 mg b.d. Three and a half years previously, he had developed severe abdominal pain and distension and was diagnosed with large bowel obstruction. At laparotomy, no mechanical obstruction was found and a defunctioning colostomy was made. Over the next 3 years, he had two further revisions to the stoma because of parastomal herniation. On the current admission, he underwent total colectomy. The histopathology showed greatly reduced colonic folds with colonic thickness of 2 mm and smooth muscle hypertrophy. There were three polyps ranging from 5 to 15 mm in diameter. There was no malignancy or diverticular disease. The findings were consistent with colonic pseudo-obstruction.Case 2: A 49-year-old woman had a history of multiple sclerosis for 12 years. This had caused severe disability. At the time of the current admission, she was unable to walk and, owing to gastroparesis and oesophageal dysmotility, was fed through a jejunostomy. She had significant cognitive impairment, had a longstanding indwelling catheter because of urinary incontinence and was incontinent of faeces. She also had depression and had recently ceased mianserin because of vomiting. Her current medications were: ranitidine 150 mg b.d., cisapride 10 mg t.d.s., salbutamol 5 mg nebule q.i.d. and sodium chromoglycate nebules 20 mg daily. She was admitted because of fever, tachycardia, tachypnoea and right basal crackles on chest auscultation. The chest X-ray was consistent with aspiration pneumonia. She was treated with oral antibiotics and improved over 5 days. On the sixth day of admission, she developed a new fever to 39°C and hypotension. She died the following day. Autopsy revealed colonic pseudo-obstruction and megacolon. There was also right lower lo...

show abstract

Inflammatory bowel disease emergencies

Cited by 31 publications

References 61 publications

Clinical Challenges: 18 Year Old Male with Bloody Diarrhea

Clinical Challenges: 18 Year Old Male with Bloody Diarrhea

Widespread Occlusive Vascular Disease in a Crohn's Disease Patient With Profound Thrombocytosis

Intestinal pseudo‐obstruction complicating multiple sclerosis

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