Extensive venous thrombosis in a pediatric patient with Crohn's disease

✍ Scribed by John F. Pohl; Arlynn Mulne; La Juan Chambers; Paul Neese

• Publisher: John Wiley and Sons
• Year: 2009
• Tongue: English
• Weight: 99 KB
• Volume: 15
• Category: Article
• ISSN: 1078-0998
• DOI: 10.1002/ibd.20745

✦ Synopsis

Thrombosis of the vena cava can occur secondary to intraabdominal disease and can be associated with abdominal pain. 1,2 Thrombosis of the major abdominal veins, including the inferior vena cava, can occur in patients with abdominal pathology, especially in the setting of genetic prothrombotic tendencies. 3 Minimal information is available regarding prothrombotic disease risk factors in children with inflammatory bowel disease (IBD).

A 14-year-old male with a history of Crohn's disease (CD) presented at our hospital with left leg swelling. He had been diagnosed with CD at 12 years of age after presenting with diarrhea, weight loss, and an elevated erythrocyte sedimentation rate. An initial endoscopic evaluation revealed granulomas in the stomach, ileum, and right colon. He had maintained remission successfully on infliximab (given every 8 weeks), 6-mercaptopurine, and lansoprazole. Two weeks prior to admission the patient had significant diarrhea that responded only to prednisone therapy. He developed symptoms of depression at that time, became bed-bound, and refused to ambulate. Six days prior to admission the patient had an acute onset of diffuse left leg pain.