Lower extremities gangrene in patient with ulcerative colitis

Objective: Increased coagulability is a rare but well-recognized feature which complicates Inflammatory Bowel Disease. Thromboembolism associated with ulcerative colitis has been reported since 1936 but there is no absolute therapeutic management protocol for thromboembolic complications yet. Case presentation: A 14-year-old girl was brought to our emergency department due to pain and paresthesia in both lower extremities and history of bloody diarrhea for 40 days before admission. Because of bloody diarrhea she underwent colonoscopy with biopsy the results were in favor of Ulcerative colitis. Pulses of both lower extremities were absent Color Doppler showed thrombosis of both iliofemoral arteries from infrarenal aorta with intact veins. Discussion: Thrombosis in arteries can usually be treated by thrombectomy, anticoagulation and compartment fasciotomy in cases of limb ischemia. It has rarely been reported thrombosis causing bilateral limb gangrene resulting in amputation. In this case due to no response to medical and surgical treatment right above and left below the knees amputation was performed with colectomy to control disease and eventually discharged after closure of ileostomy patient continued warfarin therapy.