Arteriovenous Thrombosis In Young Man With Ulcerative Colitis Combined With Acute Thiopurine-induced Pancreatitis And Reviewof The Literature

Background Inflammatory bowel disease(IBD)is a group of inflammatory conditions of the colon and small intestine.Crohn's disease and ulcerative colitis are the principal types of inflammatory bowel disease.It was first reported by Bargen etc.in 1936 that the relationship between thromboembolism and IBD,recent studies have shown that UC patients with hypercoagulable state of the blood,the probability of occurrence of blood system diseases 1%?8%,of which thromboembolic disease(thromboembolic disease,TEs)are the most common.Venous and arterial thromboembolism significantly increases the risk of complications and death in patients with UC.Current guidelines for the treatment of venous thrombosis have recommended anticoagulant therapy and there is no standardized treatment for arterial thrombosis.Purpose A case of UC comorbid thiopurine-induced pancreatitis(TIP)in a young man with arteriovenous thrombosis was reported.The clinical features of the case were summarized.Disease awareness and prevention.Method:A case of UC comorbid TIP in young males with arterialvenous thrombosis was reported in Nanfang Hospital of Southern Medical University.The clinical features,examination results,treatment methods and outcomes of the disease and comorbidities were analyzed.The literature was further analyzed and we wish to improve clinical understanding of the disease.Result:Young male patient,chronic disease course,subacute development,previously diagnosed as UC in our hospital,hormone dependence,infliximab(IFX)treatment is effective,patient hypersensitivity,can not be combined with azathioprine(AZA),The possibility of combined TIP is extremely high,due to abdominal pain,mucous bloody stool repeated hospitalization complicated by left lower limb pain,numbness,multivessel vascular embolization,occlusion by vascular CTA imaging,multiple venous thromboembolism by vascular Doppler,retrospective analysis and more After the subject consultation,anticoagulation and improvement of microcirculation were performed by interventional department and vascular surgery.Forgaty catheter thrombectomy was performed on the left femoral artery and the patient recovered well after surgery.Mesalazine,thalidomide,and oral administration were used.The new anticoagulant(Rivarshaban)is used to treat patients and the patient is currently recovering well.Conclusion:The hypercoagulable state(HCS)of active UC patients is especially obvious.There are a lot of literatures and reports.Clinically,deep vein thrombosis in the abdominal cavity and lower extremities is more common.UC patients with acute arterial thromboembolism are rare in clinical practice.ECCO's The IBD guidelines recommend routine anticoagulant therapy for all hospitalized UC patients,and outpatients should also be treated with anticoagulation as appropriate.Finding and recognizing the risk factors of hypercoagulability in active UC patients in time,strengthening the monitoring of coagulation status and pretreatment of venous thrombosis can help us to improve the severity of the disease,and carefully select therapeutic drugs to improve the prognosis of IBD patients.It is of great significance to reduce the mortality rate.