￭S-78￭
크론병 환자에서 발생한 상장간막정맥 및 간문맥 혈전증 1예
경희대학교 의과대학 내과학교실
*석화영, 이창균, 장재영, 동석호, 김효종, 김병호, 장영운
Introduction: Thrombosis is rare but serious complication of inflammatory bowel disease(IBD). Patients with IBD are 3 times more likely to experience thromboembolic complications than the general population. The cause of thrombotic complications in IBD is generally considered to be associated with hypercoagulable conditions. Pathogenesis of hypercoagulability in IBD is not well known. We present a case of a 17-year-old boy with Crohn`s disease, who developed superior mesenteric vein(SMV) and portal vein thrombosis. To our knowledge, this is the first report of venous thrombosis associated with Crohn`s disease in Korea. Case presentation: A 17-year-old boy presented with severe abdominal pain and fever. Six months ago, he had been diagnosed with Crohn`s disease by colonoscopy with biopsy and computed tomography(CT). He had been treated with mesalazine, prednisolone, and azathioprine, and was still taking 15 mg of predenisolone, 50 mg of azathioprine. A physical examination showed tachycardia and a firm, diffusely tender abdomen without signs of peritonitis. Color Doppler ultrasonography and CT revealed extensive thrombosis of the portal vein and superior mesenteric vein. The patient received intravenous heparin and he had prompt and complete remission of the symptom.
The patient was discharged home on warfarin. Discussion: Venous thrombosis is rare complication in Crohn`s disease and, to the best of our knowledge, has never been reported in the literature in Korea. The clinical significance of this complication lies in the fact that it may be confused with an exacerbation of Crohn`s disease and may lead to a delay in diagnosis and a poor clinical outcome. Therefore, it is important for the clinician to recognize this possibility in patients with Crohn`s disease.
