Delay Charline, Schwein Adeline, Lejay Anne, Gaertner Sébastien, Aleil Boris, Thaveau Fabien, Georg Yannick, Chakfe Nabil
Department of Vascular Surgery and Kidney Transplantation, University Hospital of Strasbourg, Strasbourg, France.
Department of Vascular Medicine, University Hospital of Strasbourg, Strasbourg, France.
Ann Vasc Surg. 2015 Feb;29(2):365.e5-9. doi: 10.1016/j.avsg.2014.09.025. Epub 2014 Nov 22.
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.
已知克罗恩病（CD）或溃疡性结肠炎患者发生动脉血栓栓塞并发症的风险增加。我们报告了一例33岁女性，患有克罗恩病19年，出现下肢间歇性跛行。计算机断层扫描显示腹主动脉髂动脉闭塞，从肠系膜下动脉水平延伸至双侧髂动脉分叉处。首先尝试血管腔内再通，但失败了。然后我们通过左腹膜后途径进行了主动脉双股动脉搭桥术，症状完全缓解。主动脉组织学研究显示为非特异性主动脉炎，中膜和外膜有淋巴细胞-组织细胞浸润。没有相关血管炎的迹象。根据文献综述，我们讨论了我们的手术策略以及主动脉壁炎症作为血栓形成的局部因素，这在以前从未被描述过。
