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Case Report: Inflammatory Bowel Disease and Thrombosis
Rhonda E Maneval1, Bonnie J Clemence
1College of Nursing, Michigan State University, East Lansing, Michigan (Dr Maneval); and Capital BlueCross, Harrisburg, Pennsylvania (Ms Clemence). Rhonda E. Maneval, DEd, MSN, RN, is an associate professor of nursing and serves as the director of undergraduate nursing programs in the College of Nursing, Michigan State University in East Lansing, Michigan. Bonnie J. Clemence, MSN, RN, is a concurrent review nurse for Capital BlueCross in Harrisburg, Pennsylvania. She previously was an infusion therapy nurse for 9 years. Ms Clemence is also an experienced pediatric nurse.
Patients with inflammatory bowel disease (IBD) have a greater risk for developing venous thromboembolism (VTE). Patients admitted to the hospital with IBD flares often require insertion of long-term venous access devices, such as peripherally inserted central catheters (PICCs), to provide access for medications, blood draws, fluid management, and nutrition. PICCs have been associated with an increased risk for upper extremity deep vein thrombosis. In this case study analysis, 2 patients with IBD and PICCs who developed VTE are examined. The case report includes a thorough discussion of medical history, symptomology, PICC insertion, and events leading to VTE development. A review of acquired risk factors for IBD patients and a comparison of risk factors that predisposed each to VTE are explored. These cases highlight the need for nurses and physicians to heighten surveillance and engage in proactive strategies to prevent VTE in this population of patients.
Patients with inflammatory bowel disease (IBD) have a greater risk for developing venous thromboembolism (VTE). Patients admitted to the hospital with IBD flares often require insertion of long-term venous access devices, such as peripherally inserted central catheters (PICCs), to provide access for medications, blood draws, fluid management, and nutrition. PICCs have been associated with an increased risk for upper extremity deep vein thrombosis. In this case study analysis, 2 patients with IBD and PICCs who developed VTE are examined. The case report includes a thorough discussion of medical history, symptomology, PICC insertion, and events leading to VTE development. A review of acquired risk factors for IBD patients and a comparison of risk factors that predisposed each to VTE are explored. These cases highlight the need for nurses and physicians to heighten surveillance and engage in proactive strategies to prevent VTE in this population of patients.
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