title: Aortitis and aortic occlusion in Crohn disease.
abstract: Patients with Crohn disease (CD) or ulcerative colitis are known to be at increased risk of arterial thromboembolic complications. We report the case of a 33-year-old woman suffering from CD for 19 years who presented lower limb claudication. Computed tomography scan revealed an aortoiliac occlusion extending from the level of the inferior mesenteric artery to both iliac bifurcations. Endovascular recanalization was attempted as a first option but failed. We then performed an aortobi-femoral bypass through a left retroperitoneal approach that allowed a total relief of the symptoms. Histologic study of the aorta demonstrated a nonspecific aortitis with lymphohistiocytic cell infiltration in the media and adventitia tunica. There was no signs of associated vasculitis. At the light of a literature review, we discussed our surgical strategy and the inflammation of the aortic wall as local factor of thrombosis that has never been previously described.
authors.affiliation: Department of Vascular Surgery and Kidney Transplantation, University Hospital of Strasbourg, Strasbourg, France.
authors.forename: Charline
authors.initials: C
authors.lastname: Delay
authors.affiliation: Department of Vascular Surgery and Kidney Transplantation, University Hospital of Strasbourg, Strasbourg, France.
authors.forename: Adeline
authors.initials: A
authors.lastname: Schwein
authors.affiliation: Department of Vascular Surgery and Kidney Transplantation, University Hospital of Strasbourg, Strasbourg, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Lejay
authors.affiliation: Department of Vascular Medicine, University Hospital of Strasbourg, Strasbourg, France.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Gaertner
authors.affiliation: Department of Vascular Medicine, University Hospital of Strasbourg, Strasbourg, France.
authors.forename: Boris
authors.initials: B
authors.lastname: Aleil
authors.affiliation: Department of Vascular Surgery and Kidney Transplantation, University Hospital of Strasbourg, Strasbourg, France.
authors.forename: Fabien
authors.initials: F
authors.lastname: Thaveau
authors.affiliation: Department of Vascular Surgery and Kidney Transplantation, University Hospital of Strasbourg, Strasbourg, France. Electronic address: yannick.georg@chru-strasbourg.fr.
authors.forename: Yannick
authors.initials: Y
authors.lastname: Georg
authors.affiliation: Department of Vascular Surgery and Kidney Transplantation, University Hospital of Strasbourg, Strasbourg, France.
authors.forename: Nabil
authors.initials: N
authors.lastname: Chakfe
mesh_terms: D000328:Adult; D001018:Aortic Diseases / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D001025:Aortitis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D001157:Arterial Occlusive Diseases / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D019917:Blood Vessel Prosthesis Implantation; D003424:Crohn Disease / Q000150:complications*; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply; D013927:Thrombosis / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy