Finding the Balance: Venous Thromboembolism Prophylaxis during Hematochezia in Crohn's Disease.

IF 0.5 Q4 GASTROENTEROLOGY & HEPATOLOGY Case Reports in Gastroenterology Pub Date : 2024-07-22 eCollection Date: 2024-01-01 DOI:10.1159/000540128
Kain Kim, Danielle Llanos, Christopher Ramos, Nikrad Shahnavaz, Bhavin B Adhyaru
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Abstract

Introduction: Despite heightened risk of venous thromboembolism (VTE) in hospitalized patients with inflammatory bowel disease (IBD), pharmacologic prophylaxis remains underutilized, particularly in those presenting with hematochezia. Although placement of retrievable inferior vena cava filters (rIVCF) may be considered in those with contraindications to anticoagulation and VTE risk, current recommendations from clinical guidelines are incongruent, leading to wide variation in practice.

Case presentation: This report highlights a case of rIVCF used in the management of recurrent VTEs in a patient hospitalized for persistent gastrointestinal bleeding.

Conclusion: Our case demonstrates the need for a lower threshold for initiating VTE prophylaxis in patients with active IBD, even when hematochezia is the presenting symptom. A small group of patients with recurrent VTE and clear contraindications to anticoagulation may require IVCFs, necessitating close follow-up and monitoring for filter complications.

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寻找平衡:克罗恩病患者血崩期间的静脉血栓栓塞预防。
简介:尽管住院的炎症性肠病(IBD)患者发生静脉血栓栓塞症(VTE)的风险增加,但药物预防仍未得到充分利用,尤其是在出现血性便血的患者中。虽然有抗凝禁忌症和 VTE 风险的患者可以考虑放置可回收下腔静脉滤器(rIVCF),但目前临床指南的建议并不一致,导致实践中的差异很大:本报告重点介绍了一例使用 rIVCF 治疗因持续消化道出血而住院的患者复发性 VTE 的病例:我们的病例表明,活动性 IBD 患者在开始预防 VTE 时需要降低阈值,即使以血性便血为主要症状。一小部分复发性 VTE 患者有明确的抗凝禁忌症,可能需要使用 IVCF,因此需要密切随访和监测滤器并发症。
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来源期刊
Case Reports in Gastroenterology
Case Reports in Gastroenterology Medicine-Gastroenterology
CiteScore
1.10
自引率
0.00%
发文量
99
审稿时长
7 weeks
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