Intest Res.  2020 Jan;18(1):130-133. 10.5217/ir.2019.00068.

Inflammatory bowel disease and superior mesenteric artery thromboembolism

• Nicolaides S
• Vasudevan
• Langenberg DV

• KMID: 2501375
• DOI: http://doi.org/10.5217/ir.2019.00068

Abstract

While patients with inflammatory bowel disease are known to be at increased risk of venous thromboembolism, the risk of arterial thrombosis is less well recognized. Here, we describe the case of a middle-aged female with a recent diagnosis of Crohn’s disease who presented to her local emergency department with acute abdominal pain. Subsequent investigations revealed a thrombus in the superior mesenteric artery resulting in multi-organ infarction requiring major intra-abdominal surgery and extensive resection of segments of small and large bowel.

Keyword

Inflammatory bowel disease; Ischemia; Thromboembolism

Figure

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  Fig. 1. Colonoscopic finding. Colonoscopy demonstrating patchy colitis throughout the colon.

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  Fig. 2. H&E stained slides from colonic biopsies (×200). The section shows mildly active colitis with increased mixed inflammatory cells in the lamina propria and an occasional cluster of histiocytes beneath the surface epithelium.

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  Fig. 3. Abdominal CT finding. CT of the abdomen demonstrates area of infarction within the spleen (arrow).

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  Fig. 4. CT angiogram finding. CT angiogram of the abdomen demonstrates near total occlusion of the superior mesenteric artery (arrow).

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  Fig. 5. H&E stained slides from surgical resection (×40). The section shows areas of mucosal necrosis and ulceration with transmural inflammation.

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