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Aortitis and aortic occlusion in Crohn disease
Charline Delay1, Adeline Schwein1, Anne Lejay1
1Department of Vascular Surgery and Kidney Transplantation, University Hospital of Strasbourg, Strasbourg, France.
Annals of Vascular Surgery
|December 3, 2014
Summary
Crohn disease patients face arterial clot risks. A case study shows aortitis, inflammation of the aortic wall, as a potential cause for thrombosis in Crohn disease, leading to successful surgical intervention.
Area of Science:
- Vascular Surgery
- Gastroenterology
- Pathology
Background:
- Patients with inflammatory bowel diseases like Crohn disease (CD) have an elevated risk of arterial thromboembolic events.
- The specific mechanisms linking CD to arterial thrombosis are not fully elucidated, necessitating further investigation into contributing factors.
Observation:
- A 33-year-old woman with a 19-year history of Crohn disease presented with lower limb claudication.
- Imaging revealed extensive aortoiliac occlusion, from the inferior mesenteric artery to the iliac bifurcations.
- Initial endovascular recanalization attempts were unsuccessful.
Findings:
- An aorto-bifemoral bypass was successfully performed, resolving the patient's symptoms.
- Histological examination of the aorta showed nonspecific aortitis with lymphohistiocytic infiltration of the media and adventitia.
- No evidence of systemic vasculitis was detected.
Implications:
- This case highlights aortitis as a potential local factor contributing to aortic thrombosis in Crohn disease patients.
- The findings suggest that inflammation of the aortic wall may play a previously undescribed role in arterial complications in CD.
- Surgical intervention, such as aorto-bifemoral bypass, can be effective in managing severe aortoiliac occlusive disease in this patient population.
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