Abstract
Background
Arterial thrombosis is a very rare, but recognised complication of inflammatory bowel disease that can result in significant morbidity and mortality.
Case presentation
We present the case of a 48-year-old female with previously well-controlled ulcerative colitis who presented with severe left upper quadrant abdominal pain. Imaging investigations subsequently revealed a large intra-aortic mural thrombus extending into the coeliac axis complicated by splenic infarction. This occurred in the absence of other prothrombotic states such as thrombophilias or vasculitis.
Conclusion
This case highlights the frequently overlooked association between inflammatory bowel disease and arterial thrombosis.
References
Bargen JA, Barker NW (1936) Extensive arterial and venous thrombosis complicating chronic ulcerative colitis. Arch Intern Med 58:17–31
Di Fabio F, Obrand D, Satin R et al (2009) Intra-abdominal venous and arterial thromboembolism in inflammatory bowel disease. Dis Colon Rectum 52:336–342
Jackson LM, O’Gorman PJ, O’Connell J et al (1997) Thrombosis in inflammatory bowel disease: clinical setting, procoagulant profile and factor V Leiden. Qjm 90:183–188
Lehmann JM, Shnaker A, Silverberg D et al (2001) Arterial thromboembolism from a distal aortic thrombus in a patient with Crohn’s disease. Isr Med Assoc J 3:226–227
Grothues F, Welte T, Grote HJ et al (2002) Floating aortic thrombus in systemic aspergillosis and detection by transesophageal echocardiography. Crit Care Med 30:2355–2358
Mikroulis DA, Antypas GD, Fournogerakis SD et al (1999) Arterial thrombosis in ulcerative colitis: case report. Int J Angiol 8:62–64
Novacek G, Haumer M, Schima W et al (2004) Aortic mural thrombi in patients with inflammatory bowel disease: report of two cases and review of the literature. Inflamm Bowel Dis 10:430–435
Novotny DA, Rubin RJ, Slezak FA et al (1992) Arterial thromboembolic complications of inflammatory bowel disease. Report of three cases. Dis Colon Rectum 35:193–196
Perler BA, Kadir S, Williams GM (1991) Aortic mural thrombus in young women: premature arteriosclerosis or separate clinical entity? Surgery 110:912–916
Szychta P, Reix T, Sevestre MA et al (2001) Aortic thrombosis and ulcerative colitis. Ann Vasc Surg 15:402–404
Talbot RW, Heppell J, Dozois RR et al (1986) Vascular complications of inflammatory bowel disease. Mayo Clin Proc 61:140–145
Hahn TL, Dalsing MC, Sawchuk AP et al (1999) Primary aortic mural thrombus: presentation and treatment. Ann Vasc Surg 13:52–59
Hudson M, Chitolie A, Hutton RA et al (1996) Thrombotic vascular risk factors in inflammatory bowel disease. Gut 38:733–737
Conflict of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kok, H.K., Maguire, S., Corr, A. et al. Intra-aortic mural thrombosis and splenic infarction in association with ulcerative colitis. Ir J Med Sci 181, 377–379 (2012). https://doi.org/10.1007/s11845-010-0472-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11845-010-0472-8