Yang Dong Jin, Park Young Sook, Yu Yeon Hwa, Jo Yun Ju, Kim Seong Hwan, Jung Yoon Young, Hwang Young Hwan, Jun Dae Won
Department of Internal Medicine, Eulji University College of Medicine, Seoul, Korea.
Korean J Gastroenterol. 2009 Oct;54(4):248-51. doi: 10.4166/kjg.2009.54.4.248.
Venous thrombosis and thromboembolism appear to occur more often in patient with inflammatory bowel disease (IBD). The cause of thrombotic complications in IBD is generally considered to be associated with hypercoagulable conditions. Its prevalence rate ranges from 1% to 8% in clinical studies and rises to 39% in autopsy, but the renal vein thrombosis is very rare complication in ulcerative colitis patient. A 24-year-old man presented with intermittent abdominal pain and hematochezia for 6 months and recently developed pitting edema for few weeks. He was diagnosed as severe ulcerative colitis involving whole colon combined with thrombosis in both renal veins by colonoscopy and computed tomography scan of abdomen. We used steroid for the treatment of ulcerative colitis and both intravenous lower molecular weight heparin and warfarin for renal vein thrombosis. His symptoms were improved after treatment and maintained with mesalazine and warfarin. Follow-up abdominal CT scan showed complete resolution of both renal vein thrombosis. Currently he has been followed up for 2 years with oral mesalazine.
静脉血栓形成和血栓栓塞在炎症性肠病（IBD）患者中似乎更常发生。IBD 中血栓形成并发症的原因通常被认为与高凝状态有关。在临床研究中，其患病率为 1%至 8%，在尸检中升至 39%，但肾静脉血栓形成在溃疡性结肠炎患者中是非常罕见的并发症。一名 24 岁男性出现间歇性腹痛和便血 6 个月，最近几周出现凹陷性水肿。通过结肠镜检查和腹部计算机断层扫描，他被诊断为重度溃疡性结肠炎累及全结肠并伴有双侧肾静脉血栓形成。我们使用类固醇治疗溃疡性结肠炎，并使用静脉注射低分子量肝素和华法林治疗肾静脉血栓形成。治疗后他的症状有所改善，并使用美沙拉嗪和华法林维持治疗。随访腹部 CT 扫描显示双侧肾静脉血栓形成完全消退。目前他口服美沙拉嗪已随访 2 年。
