Combined inferior vena cava & renal vein thromboses: Case and synopsis of thromboembolism in inflammatory bowel disease

Thromboembolic phenomena have long been known to be an extraintestinal manifestation of inflammatory bowel disease, with the deep veins of the legs and the pulmonary vasculature being the most commonly affected sites. Research has identified factors associated with inflammatory bowel disease that contribute to prothrombotic risk, but understanding of the pathophysiology is incomplete. Symptoms of thromboembolism can be vague, may be overlooked, or may be attributed to the consequences of protracted inflammatory bowel disease and/or side effects of its medications. We present a rare case of combined inferior vena cava and bilateral renal vein thromboses as well as pulmonary embolism in a young woman with ulcerative pancolitis in partial remission. Our patient presented with nonspecific symptoms that would not immediately raise clinical suspicion of severe thromboembolism, and thus we provide our recommendations for diagnosis and treatment.