Arterial thromboembolic complications of inflammatory bowel disease
Extraintestinal manifestations of inflammatory bowel disease are legion and are demonstrated in one-third of those afflicted. In general, they do not mandate surgery. Three patients with active pancolonic ulcerative colitis developed arterial thromboembolic complications prior to surgical treatment. Thromboembolic complications are not fully understood, as is evidenced by the paucity of information in the literature, and only sporadic cases of arterial thromboemboli are found. These have been described primarily in the postsurgical patient. To ascertain whether others have encountered similar cases, a survey form was distributed to members of The American Society of Colon and Rectal Surgeons, yielding an additional 54 patients with thromboembolic complications. Approximately two-thirds were deep venous thromboses and/or pulmonary emboli. Ten patients had cerebrovascular accidents, and eight had arterial emboli. Eleven patients, over 21 percent, suffered multiple events. There were four resultant mortalities. An arterial thromboembolic event in a patient with ulcerative colitis is usually associated with pancolonic disease, has a poor long-term prognosis, and is an indication for colectomy.
Key wordsArterial thromboembolism Ulcerative colitis Crohn's disease Inflammatory bowel disease
Unable to display preview. Download preview PDF.
- 3.Bargen JA, Barker NW. Extensive arterial and venous thrombosis complicating chronic ulcerative colitis. Arch Intern Med 1936;58:17–31.Google Scholar
- 4.Braverman D, Bogoch A. Arterial thrombosis in ulcerative colitis. Dig Dis Sci 1978;23:1148–50.Google Scholar
- 7.Spittell JA, Owen CA Jr, Thompson JH Jr, Sauer WG. Hypercoagulability and thrombosis in chronic ulcerative colitis. Coll Papers Mayo Clin (1963 & 1964); 55:53–7.Google Scholar