Tabibian James H, Lada Samuel J, Tabibian Neshan
Geffen School of Medicine at UCLA, Los Angeles, California, USA.
Medscape J Med. 2008 Jan 9;10(1):6.
Thromboembolic phenomena have long been known to be an extraintestinal manifestation of inflammatory bowel disease, with the deep veins of the legs and the pulmonary vasculature being the most commonly affected sites. Research has identified factors associated with inflammatory bowel disease that contribute to prothrombotic risk, but understanding of the pathophysiology is incomplete. Symptoms of thromboembolism can be vague, may be overlooked, or may be attributed to the consequences of protracted inflammatory bowel disease and/or side effects of its medications. We present a rare case of combined inferior vena cava and bilateral renal vein thromboses as well as pulmonary embolism in a young woman with ulcerative pancolitis in partial remission. Our patient presented with nonspecific symptoms that would not immediately raise clinical suspicion of severe thromboembolism, and thus we provide our recommendations for diagnosis and treatment.
长期以来，血栓栓塞现象一直被认为是炎症性肠病的一种肠外表现，腿部深静脉和肺血管是最常受累的部位。研究已经确定了与炎症性肠病相关的导致血栓形成风险增加的因素，但对其病理生理学的理解并不完整。血栓栓塞的症状可能不明确，可能被忽视，或者可能归因于炎症性肠病病程迁延及其药物的副作用。我们报告了一例罕见病例，一名处于部分缓解期的溃疡性全结肠炎年轻女性合并下腔静脉和双侧肾静脉血栓形成以及肺栓塞。我们的患者表现出非特异性症状，不会立即引起对严重血栓栓塞的临床怀疑，因此我们提供了诊断和治疗建议。
