Venous thromboembolism with infl ammatory bowel disease

Abstract

Venous thrombosis and thromboembolism appear to be increased in patients with inflammatory bowel disease. Although several acquired and genetic risk factors are known, about half that develop a thromboembolic event have no identifiable risk factor. Control of the inflammatory process is thought to be the key factor in risk reduction for thrombotic events. Prophylactic use of anticoagulants is not universally recommended, but possible use should be reviewed in an individual patient after evaluation of the risks, such as hemorrhage, compared to potential benefits. Particular consideration should be given if there has been a prior thrombotic event, if hospitalization will require surgery, or if an underlying coagulation disorder is present.

Spontaneous ventricular thrombosis in patients with inflammatory bowel disease

“…The overall incidence of thrombotic events in patients with inflammatory bowel disease is estimated to be 1-8%, which is approximately threefold greater than that of the general population. 9,10 Thrombosis most commonly occurs in the lower extremities, lungs, brain, and liver. 9 More than half of the thrombotic events occur during an exacerbation of inflammatory bowel disease.…”

Ulcerative Colitis Diagnosed in a Patient with Venous Thromboembolism

“…12 Although prophylactic anticoagulation with heparin is not recommended for all IBD patients, it should be implemented when the benefit for prophylaxis outweighs the relative contraindication with rectal bleeding. 21 As discussed earlier, lifelong anticoagulation with warfarin should be considered when concurrent thrombophilia exists. 6 Temporary prophylactic anticoagulation with either LMWH or UFH should be strongly considered in high-risk situations (eg, immobilization or during the perioperative period), unless a contraindication for active bleeding coexists.…”

Left Ventricular Thrombus and Cardioembolic Stroke in a Patient with Ulcerative Colitis

“…Patients with inflammatory bowel disease (IBD) are at increased risk of developing thromboembolic complications. [ 1 2 3 4 5 6 ] The venous system is most commonly involved, manifesting as peripheral venous thrombosis, with or without pulmonary embolism. In a large series involving patients with IBD flare-up, the absolute risk of venous thromboembolism (VTE) in hospitalized patients was 37.5/1000 person-years as compared to 13.9/1000 person-years in the control group.…”