Successful treatment of extensive splanchnic arterial and portal vein thrombosis associated with ulcerative colitis.
Venous and arterial thromboembolism is a significant cause of morbidity and mortality in patients with ulcerative colitis (UC). Arterial thrombosis of the splanchnic region is a rare event with a very high mortality rate. Furthermore, it represents a challenging complication since it tends to be overlooked and misinterpreted as a clinical exacerbation of UC. We present the case of a 62-year-old female with pancolonic UC complicated by an extensive arterial thrombosis involving the aorta, the celiac trunk, the hepatic, gastric and splenic arteries and the superior mesenteric artery. A thrombosis of the splenic vein extending into the proximal portal vein was also present. The patient was successfully treated by a combined interventional-radiological and surgical treatment. We discuss the rationale behind our management of this case and review the literature on splanchnic arterial thrombosis associated with UC.
Di Fabio
F
F
Division of Colon & Rectal Surgery, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, Quebec, Canada.
Obrand
D
D
Satin
R
R
Gordon
P H
PH
D000925:Anticoagulants / Q000008:administration & dosage*; D003093:Colitis, Ulcerative / Q000150:complications*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D017538:Mesenteric Artery, Superior / Q000473:pathology; D008641:Mesenteric Vascular Occlusion / Q000188:drug therapy* / Q000209:etiology*; D008875:Middle Aged; D011169:Portal Vein / Q000473:pathology; D013157:Splenic Artery / Q000473:pathology; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D020246:Venous Thrombosis / Q000150:complications / Q000188:drug therapy / Q000209:etiology
D000925:Anticoagulants; D010959:Tissue Plasminogen Activator