Case Report

Inflammatory Bowel Disease-Related Thoracic Aortic Thrombosis

Authors: Kareem Elder, MD, Riem Hawi, MD, Firas Al Solaiman, MD


Arterial and venous thromboembolisms have long been associated with inflammatory bowel disease (IBD) and can cause significant morbidity and mortality. We present a patient with aortic arch thrombosis embolizing to the left lower extremity during hospitalization for active ulcerative colitis (UC). The limb was preserved following emergent embolectomy. Thrombophilia was attributed to UC, as hypercoagulable testing was negative. IBD is certainly a hypercoagulable state, and aggressive thromboembolism prevention should be considered for hospitalized patients with active disease.

Key Points

* Inflammatory bowel disease is a hypercoagulable condition, especially during active disease.

* Thrombosis can involve both venous and arterial vasculature.

* The site of thrombosis can be distant from gastrointestinal/inflamed organs.

* Severe thrombosis may require immediate surgical intervention.

* Effective prophylactic anticoagulation recommendations should be assessed in randomized clinical trials.

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