Severe ulcerative colitis complicated by an arterial thrombus in the brachiocephalic trunk

Haumer, Markus; Teml, Alexander; Dirisamer, Albert; Vogelsang, Harald; Koppensteiner, Renate; Novacek, Gottfried

doi:10.1002/ibd.20116

Cited by 6 publications

(4 citation statements)

References 9 publications

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“…However, numerous case reports and case series have reported ATE in patients with IBD. ATE may involve thrombosis and/or occlusion of the cerebral [ 66 , 67 ], splanchnic [ 68 ], carotid [ 69 ], coronary [ 70 ], aorta [ 71 ], renal, and upper and lower extremity [ 72 ] arteries. Incidence is more common after interventional procedures, however, can occur spontaneously.…”

Section: Thromboembolic Events In Patients With Ibdmentioning

confidence: 99%

Thromboembolic Events in Patients with Inflammatory Bowel Disease: A Comprehensive Overview

et al. 2022

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Inflammatory bowel disease (IBD), Crohn’s disease and ulcerative colitis are chronic inflammatory disorders of the intestines. The underlying inflammation activates the coagulation cascade leading to an increased risk of developing arterial and venous thromboembolic events such as deep vein thrombosis and pulmonary embolism. Patients with IBD are at a 2–3-fold increased risk of developing thromboembolism. This risk increases in patients with active IBD disease, flare-ups, surgery, steroid treatment, and hospitalization. These complications are associated with significant morbidity and mortality making them important in clinical practice. Clinicians should consider the increased risk of thromboembolic events in patients with IBD and manage them with appropriate prophylaxis based on the risk. In this review, we discuss the literature associated with the pathophysiology of thromboembolism in patients with IBD, summarize the studies describing the various thromboembolic events, and the management of thromboembolism in patients with IBD.

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Section: Thromboembolic Events In Patients With Ibdmentioning

confidence: 99%

Thromboembolic Events in Patients with Inflammatory Bowel Disease: A Comprehensive Overview

et al. 2022

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“…15 There are a number of case reports describing spontaneous thromboembolism in the upper extremity in the setting of UC. [1][2][3] One case reports describes a 58 year old woman with a history of severe UC presenting with severe ischemic rest pain due to a brachiocephalic trunk thrombosis resulting in ipsilateral hand microembolism. She was treated successfully with IV unfractionated heparin and transvenous lysis block of the forearm.…”

Section: Effects Of Ulcerative Colitis and Inflammatory Conditions On...mentioning

confidence: 99%

“…She was treated successfully with IV unfractionated heparin and transvenous lysis block of the forearm. 1 Another case report describes a 47 year old male treated for new onset UC with brachial, radial, and ulnar arterial thrombi. He required a distal brachial artery arteriotomy and Fogarty catheter removal of the thrombus with a 14-day course of heparin.…”

Section: Effects Of Ulcerative Colitis and Inflammatory Conditions On...mentioning

confidence: 99%

“…Ulcerative colitis has been implicated in both arterial (ATE) and venous thromboembolic events (VTE), with several reported cases of embolic events in the upper extremity. [1][2][3] However, all reported cases are in the setting of spontaneous embolic events not associated with surgery; [1][2][3] the effect of this disease in the setting of elective procedures is unknown. Similarly, pregnancy is a hypercoagulable physiological state, with increased rates of thromboembolism reported following abdominal surgery in comparison to their non-pregnant cohort.…”

Section: Introductionmentioning

confidence: 99%

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Digit Necrosis After Hand Surgery in Pregnancy: A Case Report

Ziolkowski

Dengler

Goldberg

2021

Plastic Surgery Case Studies

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Digital blocks are routinely used for excision of lesions. We describe a unique presentation of digit necrosis after excisional biopsy with digital block and finger tourniquet in a pregnant patient with a history of ulcerative colitis. The patient had a history of a long-standing painful dorsal PIP joint mass and was scheduled for excision under local anaesthetic. On the day of the procedure, she disclosed that she was pregnant in the second trimester. After extensive discussion of risks and benefits between the patient and the surgeon, the decision was made to proceed with an excisional biopsy of the lesion because of its impact on her quality of life. Twelve hours after the procedure, she presented to the emergency department with blistering and severe pain to the digit. Doppler ultrasound showed flow through both digital arteries and the digit appeared viable. Over the coming days her pain continued to worsen and on post-operative day 3, she was admitted to hospital for attempted salvage of the digit using conservative methods. Her digit went on to demarcate at the level of the middle phalanx. Five weeks after her initial procedure, the patient underwent partial amputation of the small finger at the level of the DIP joint and 2-stage groin flap for soft tissue coverage. We discuss the effects of pregnancy and ulcerative colitis on thromboembolic events, and review the literature on digital blocks, digital tourniquet use and management of early digit necrosis. This case highlights the importance of delaying elective hand procedures in pregnant patients, especially if they have additional comorbidities such as pro-thrombotic diseases like inflammatory bowel disease.

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Intra-Abdominal Venous and Arterial Thromboembolism in Inflammatory Bowel Disease

Fabio

Obrand

Satin

et al. 2009

Diseases of the Colon &Amp; Rectum

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Venous and arterial thromboembolism constitutes a significant cause of morbidity and mortality in patients with inflammatory bowel disease. The most common thrombotic manifestations are lower extremity deep vein thromboses with or without pulmonary embolism. Occasionally, thromboembolic events occur in the main abdominal vessels, such as the portal and superior mesenteric veins, vena cava and hepatic vein, aorta, splanchnic and iliac arteries, or in the limb arteries. The decision-making process for the treatment of these uncommon thromboembolic complications in inflammatory bowel disease may be very challenging for several reasons: 1) no standardized therapies are available; 2) the decision of starting anticoagulant therapy implies the potential risk of intestinal bleeding; 3) thromboembolic events may recur and be life-threatening if inadequately treated. The literature was searched by using MEDLINE, Embase, and the Cochrane library database. Studies published between 1970 and 2007 were reviewed. We discuss the medical and surgical therapeutic options that should be considered to optimize the outcome and reduce the risk of complications in abdominal thromboembolisms associated with inflammatory bowel disease.

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Severe ulcerative colitis complicated by an arterial thrombus in the brachiocephalic trunk

Cited by 6 publications

References 9 publications

Thromboembolic Events in Patients with Inflammatory Bowel Disease: A Comprehensive Overview

Thromboembolic Events in Patients with Inflammatory Bowel Disease: A Comprehensive Overview

Digit Necrosis After Hand Surgery in Pregnancy: A Case Report

Intra-Abdominal Venous and Arterial Thromboembolism in Inflammatory Bowel Disease

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