Intestinal Research

Original Articles

Appropriate J-pouch volume associated with improved clinical outcomes and long-term quality of life in patients with ulcerative colitis after ileal pouch-anal anastomosis: results from China UC Pouch Center Union: Weimin Xu, Zhujiang Dai, Wenjun Ding, Long Cui, Xiaojian Wu, Wei Zhou, Zhao Ding, Peng Du; Received January 4, 2026 Accepted February 23, 2026 Published online May 7, 2026; DOI: https://doi.org/10.5217/ir.2026.00003 [Epub ahead of print]

Abstract PDF: Background/Aims
A well-functioning and well-constructed pouch is crucial for the long-term quality of life (QOL) in ulcerative colitis (UC) patients after ileal pouch-anal anastomosis (IPAA). What pouch volume is appropriate to construct to maintain satisfactory pouch function for better long-term prognosis remains unknown.
Methods
UC patients who underwent IPAA from January 2008 to January 2024 in our pouch surgery centers affiliated with the China UC Pouch Center Union were enrolled. The primary outcomes were the occurrence of postoperative complications and impaired long-term QOL.
Results
A total of 222 eligible UC patients with a median follow-up time of 8.0 years (interquartile range, 4.0–10.3 years) were enrolled. Among the patients, 117 (52.7%) had a pouch with volume <120 mL, whereas 105 (47.3%) had a pouch volume ≥120 mL. We found that patients with pouch volume ≥ 120 mL were more likely to achieve significantly improved long-term QOL (P= 0.013), better bowel function (P= 0.030) as well as have decreased risk of late postoperative complications (P= 0.005), mainly presented as pouchitis (P= 0.039). Furthermore, we demonstrated that a small pouch with volume < 120 mL is an independent risk factor for the development of late postoperative complications (odds ratio, 2.157; P= 0.013) and impaired long-term QOL (odds ratio, 2.049; P= 0.018).
Conclusions
A J-pouch volume ≥ 120 mL could be a considerable option for colorectal surgeons in pouch configurations to achieve better long-term prognosis.

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Miscellaneous

Bowel movement alterations predict the severity of diverticular disease and the risk of acute diverticulitis: a prospective, international study: Antonio Tursi, Daniele Piovani, Giovanni Brandimarte, Francesco Di Mario, Walter Elisei, Marcello Picchio, Gisella Figlioli, Gabrio Bassotti, Leonardo Allegretta, Maria Laura Annunziata, Mauro Bafutto, Maria Antonia Bianco, Raffaele Colucci, Rita Conigliaro, Dan L. Dumitrascu, Ricardo Escalante, Luciano Ferrini, Giacomo Forti, Marilisa Franceschi, Maria Giovanna Graziani, Frank Lammert, Giovanni Latella, Daniele Lisi, Giovanni Maconi, Debora Compare, Gerardo Nardone, Lucia Camara de Castro Oliveira, Chaves Oliveira Enio, Savvas Papagrigoriadis, Anna Pietrzak, Stefano Pontone, Ieva Stundiene, Tomas Poškus, Giuseppe Pranzo, Matthias Christian Reichert, Stefano Rodino, Jaroslaw Regula, Giuseppe Scaccianoce, Franco Scaldaferri, Roberto Vassallo, Costantino Zampaletta, Angelo Zullo, Erasmo Spaziani, Stefanos Bonovas, Alfredo Papa, Silvio Danese, DICA International Group; Intest Res 2025;23(1):96-106. Published online August 12, 2024; DOI: https://doi.org/10.5217/ir.2024.00046

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Background/Aims
Patients with diverticular disease (DD) frequently have abnormal bowel movements. However, it is unknown whether the entity of these alterations is associated with the severity of DD. We aimed to assess bowel habits and their relationship with the severity of DD according to Diverticular Inflammation and Complication Assessment (DICA) classification, Combined Overview on Diverticular Assessment (CODA) score, and fecal calprotectin (FC).
Methods
An international, multicenter, prospective cohort study was conducted in 43 centers. A 10-point visual analog scale (VAS) was used to assess the severity of constipation and diarrhea. The association of constipation and diarrhea with DICA classification, CODA score, and basal FC was tested using non-parametric tests. Survival methods for censored observations were applied to test the association of constipation and diarrhea with the incidence of acute diverticulitis over a 3-year follow-up.
Results
Of 871 patients with DD were included in the study. Of these, 208 (23.9%) and 199 (22.9%) reported a VAS score for constipation and diarrhea at least 3 at baseline, respectively. Higher constipation and diarrhea scores were associated with increasing DICA classification, CODA score and basal FC (P< 0.001). Constipation and diarrhea scores were independently associated with an increased hazard of developing acute diverticulitis (hazard ratio [HR]_constipation = 1.15 per 1-VAS point increase, 95% confidence interval [CI], 1.04–1.27; P=0.004; and HR_diarrhea =1.14; 95% CI, 1.03–1.26; P=0.014, respectively).
Conclusions
In newly diagnosed patients with DD, higher endoscopic and combined scores of DD severity were associated with higher scores of constipation and diarrhea at baseline. Both constipation and diarrhea were independent prognostic factors of acute diverticulitis.

Citations

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Global guidelines on diverticular disease of the colon: the Fiesole Consensus report
Antonio Tursi, Giovanni Brandimarte, Francesco Di Mario, Wenjie Ma, Juozas Kupcinskas, Jaroslaw Regula, Giovanni Maconi, Peter Malfertheiner, Giovanni Barbara, Neil Stollman, Savvas Papagrigoriadis, Thomas Golda, Antonio Amato, Mauro Bafutto, Gabrio Basso
Gut.2025; : gutjnl-2025-336902. CrossRef

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IBD

Laparoscopic surgery contributes to a decrease in short-term complications in surgical ulcerative colitis patients during 2008–2017: a multicenter retrospective study in China: Zerong Cai, Xiaosheng He, Jianfeng Gong, Peng Du, Wenjian Meng, Wei Zhou, Jinbo Jiang, Bin Wu, Weitang Yuan, Qi Xue, Lianwen Yuan, Jinhai Wang, Jiandong Tai, Jie Liang, Weiming Zhu, Ping Lan, Xiaojian Wu; Intest Res 2023;21(2):235-243. Published online December 2, 2022; DOI: https://doi.org/10.5217/ir.2022.00012

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Background/Aims
The aim of this study was to analyze the chronological changes in postoperative complications in surgical ulcerative colitis patients over the past decade in China and to investigate the potential parameters that contributed to the changes.
Methods
Ulcerative colitis patients who underwent surgery during 2008–2017 were retrospectively enrolled from 13 hospitals in China. Postoperative complications were compared among different operation years. Risk factors for complications were identified by logistic regression analysis.
Results
A total of 446 surgical ulcerative colitis patients were analyzed. Fewer short-term complications (24.8% vs. 41.0%, P=0.001) and more laparoscopic surgeries (66.4% vs. 25.0%, P<0.001) were found among patients who received surgery during 2014–2017 than 2008–2013. Logistic regression suggested that independent protective factors against short-term complications were a higher preoperative body mass index (odds ratio [OR], 0.870; 95% confidence interval [CI], 0.785–0.964; P=0.008), laparoscopic surgery (OR, 0.391; 95% CI, 0.217–0.705; P=0.002) and elective surgery (OR, 0.213; 95% CI, 0.067–0.675; P=0.009). The chronological decrease in short-term complications was associated with an increase in laparoscopic surgery.
Conclusions
Our data revealed a downward trend of short-term postoperative complications among surgical ulcerative colitis patients in China during the past decade, which may be due to the promotion of minimally invasive techniques among Chinese surgeons.

Citations

Citations to this article as recorded by

Surgical trend including minimally invasive surgeries for ulcerative colitis in the COSUC study: the largest multicenter cohort study in Japan
Koya Hida, Yoshiki Okita, Yusuke Fujii, Toru Miyake, Yoshiaki Kuriu, Yu Hidaka, Tomohiro Arita, Kiyotaka Kawaguchi, Shingo Ochi, Yusuke Fujita, Kazutaka Obama, Takeshi Naitoh, Nobuhisa Matsuhashi, Yudai Fukui, Shintaro Kohama, Manabu Takata, Shin Takesue,
Surgical Endoscopy.2025; 39(6): 3911. CrossRef
Surgical Options for Appropriate Length of J-Pouch Construction for Better Outcomes and Long-term Quality of Life in Patients with Ulcerative Colitis after Ileal Pouch-Anal Anastomosis
Weimin Xu, Wenbo Tang, Wenjun Ding, Zhebin Hua, Yaosheng Wang, Xiaolong Ge, Long Cui, Xiaojian Wu, Wei Zhou, Zhao Ding, Peng Du
Gut and Liver.2024; 18(1): 85. CrossRef
Time trend in surgical indications and outcomes in ulcerative colitis—A two decades in-depth retrospective analysis
Guillaume Le Cosquer, Lena Capirchio, Pauline Rivière, Marie Armelle Denis, Florian Poullenot, Christophe Remue, Frank Zerbib, Daniel Leonard, Bertrand Célérier, Alex Kartheuser, David Laharie, Olivier Dewit
Digestive and Liver Disease.2023; 55(10): 1338. CrossRef
Surgical Treatment in Ulcerative Colitis, Still Topical: A Narrative Review
Eduard Slonovschi, Pratyusha Kodela, Monalisa Okeke, Sandeep Guntuku, Shanmukh Sai Pavan Lingamsetty
Cureus.2023;[Epub] CrossRef
Surgical outcomes and stoma-related complications in inflammatory bowel disease in Saudi Arabia: a retrospective study
Thamer A. Bin Traiki, Sulaiman A. Alshammari, Mansoor A. Abdulla, Fayez G. Aldarsouni, Noura S. Alhassan, Maha-Hamdien Abdullah, Awadh Alqahtani, Khayal A. Alkhayal
Annals of Saudi Medicine.2023; 43(6): 386. CrossRef

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IBD

Vedolizumab does not increase perioperative surgical complications in patients with inflammatory bowel disease, cohort study: Vitaliy Y. Poylin, Jose Cataneo Serrato, Jonathan Pastrana Del Valle, Joseph D. Feuerstein; Intest Res 2022;20(1):72-77. Published online February 3, 2021; DOI: https://doi.org/10.5217/ir.2020.00117

Abstract PDF PubReader ePub

Background/Aims
Biologics are increasingly used to manage ulcerative colitis (UC) and Crohn’s disease (CD). However, even with earlier usage of biologic therapy, a significant proportion of patients will require surgery. Vedolizumab is an anti-integrin antibody that is increasingly used given that it is more gut selective and associated with fewer side effects. The aim of this study is to assess the effect of vedolizumab compared to anti-tumor necrosis factor (anti-TNF) therapy on the perioperative complications in patients undergoing surgery for inflammatory bowel disease (IBD).
Methods
Retrospective review of patients treated for IBD at a tertiary care center between 2013 and 2017. Rates of 30- and 90-day complications for patients on vedolizumab were compared to patients on anti-TNF regimens.
Results
One hundred and ninety-nine patients met inclusion criteria with 87 (43%) patients undergoing surgery for CD, 111 (55.8%) for UC and 1 (0.5%) for indeterminate colitis. Thirty-eight patients received preoperative vedolizumab and 94 received anti-TNF. There were more males and lower body mass index in the anti-TNF group. There was no significant difference in overall rate of complications at 30 or 90 days. There was a trend for lower leak rate vedolizumab group (0% for vedolizumab vs. 2.1% for anti-TNF at 30 days, P= 1.00; 0% for vedolizumab vs. 1.1% for anti-TNF at 90 days, P= 1.00). Multivariate analysis showed low albumin ( < 3.6 g/dL) at the time of surgery to be a significant risk factor for overall and infectious complications at 90 days (odds ratio, 3.24; 95% confidence interval, 1.12–8.79; P= 0.021).
Conclusions
Perioperative vedolizumab does not increase rates of perioperative complications in IBD surgery when compared to anti-TNF medications.

Citations

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Newer Immunosuppressants for Rheumatologic Disease
Ye Rin Koh, Kenneth C. Cummings
Rheumatic Disease Clinics of North America.2025; 51(2): 383. CrossRef
The Effects of the Biological Agents Infliximab, Vedolizumab, and Ustekinumab on Intestinal Anastomosis: An Experimental Study in Rats
Alexandra Menni, Georgios Tzikos, Patroklos Goulas, George Chatziantoniou, Angeliki Vouchara, Athanasios S. Apostolidis, Aristeidis Ioannidis, Georgios Germanidis, Lyssimachos G. Papazoglou, Olga Giouleme, Stylianos Apostolidis
Biomedicines.2025; 13(5): 1079. CrossRef
Real-World Safety of Vedolizumab in Inflammatory Bowel Disease: A Retrospective Cohort Study Supported by FAERS Signal Analysis
Bojana Milašinović, Sandra Vezmar Kovačević, Srđan Marković, Marija Jovanović, Tamara Knežević Ivanovski, Đorđe Kralj, Petar Svorcan, Branislava Miljković, Katarina Vučićević
Pharmaceuticals.2025; 18(8): 1127. CrossRef
Refractory Ulcerative Colitis Successfully Treated With a Combination of Granulocyte and Monocyte Apheresis and Mirikizumab: A Case Report
Tomotaka Tanaka, Yoshikazu Yoshifuku, Hajime Teshima, Kazuyoshi Nakata, Kosei Kitamura, Nodoka Otabe, Takeshi Mori, Songde Cho, Michihiro Nonaka, Yoshifumi Fujimoto
Cureus.2025;[Epub] CrossRef
Comparative Risk of Complications Following Intestinal Surgery After Infliximab, Vedolizumab, or Ustekinumab Treatment: Systematic Review & Meta-Analysis
Alexandra-Eleftheria Menni, Georgios Tzikos, George Petrakis, Patroklos Goulas, Panagiotis V. Karathanasis, Stylianos Apostolidis
Pharmaceuticals.2025; 18(10): 1466. CrossRef
Safety and Monitoring of Inflammatory Bowel Disease Advanced Therapies
Shubha Bhat, Benjamin Click, Miguel Regueiro
Inflammatory Bowel Diseases.2024; 30(5): 829. CrossRef
Newer Immunosuppressants for Rheumatologic Disease
Ye Rin Koh, Kenneth C. Cummings
Anesthesiology Clinics.2024; 42(1): 131. CrossRef
Peri-Operative Optimization of Patients with Crohn’s Disease
Hareem Syed, Ahmed Nadeem, David Gardinier, Kendra Weekley, Dovid Ribakow, Stephen Lupe, Shubha Bhat, Stefan Holubar, Benjamin L. Cohen
Current Gastroenterology Reports.2024; 26(5): 125. CrossRef
Clinical Significance of Prognostic Nutrition Index in Patients with Crohn’s Disease after Primary Bowel Resection
Hyeon Woo Bae, Yong Joon Lee, Min Young Park, Seung Yoon Yang, Yoon Dae Han, Min Soo Cho, Hyuk Hur, Kang Young Lee, Jae Hee Cheon, Joseph C. Carmichael, Byung Soh Min
Yonsei Medical Journal.2024; 65(7): 380. CrossRef
Rates of Adverse Events in Patients With Ulcerative Colitis Undergoing Colectomy During Treatment With Tofacitinib vs Biologics: A Multicenter Observational Study
Gabriele Dragoni, Tommaso Innocenti, Aurelién Amiot, Fabiana Castiglione, Laura Melotti, Stefano Festa, Edoardo Vincenzo Savarino, Marie Truyens, Konstantinos Argyriou, Daniele Noviello, Tamas Molnar, Vincent Bouillon, Cristina Bezzio, Piotr Eder, Samuel
American Journal of Gastroenterology.2024; 119(8): 1525. CrossRef
Newer Immunosuppressants for Rheumatologic Disease
Ye Rin Koh, Kenneth C. Cummings
Rheumatic Disease Clinics of North America.2024; 50(3): 545. CrossRef
Full Guidelines—From the Medical Board of the National Psoriasis Foundation: Perioperative management of systemic immunomodulatory agents in patients with psoriasis and psoriatic arthritis
Warren A. James, Angela L. Rosenberg, Jashin J. Wu, Sylvia Hsu, April Armstrong, Elizabeth B. Wallace, Lara Wine Lee, Joseph Merola, Sergio Schwartzman, Dafna Gladman, Clive Liu, John Koo, Jason E. Hawkes, Soumya Reddy, Ron Prussick, Paul Yamauchi, Michae
Journal of the American Academy of Dermatology.2024; 91(2): 251.e1. CrossRef
Tofacitinib Exposure Does Not Increase Postoperative Complications Among Patients With Ulcerative Colitis Undergoing Total Colectomy: A Retrospective Case–Control Study
Ibrahim Gomaa, Sara Aboelmaaty, Himani Bhatt, Robert A. Vierkant, Sherief F. Shawki, David W. Larson, Kevin T. Behm, Kristen K. Rumer
Diseases of the Colon & Rectum.2024; 67(11): 1443. CrossRef
An update on the safety of long-term vedolizumab use in inflammatory bowel disease
Sailish Honap, Patrick Netter, Silvio Danese, Laurent Peyrin-Biroulet
Expert Opinion on Drug Safety.2023; 22(9): 767. CrossRef
Perioperative Management of Pediatric Crohn’s Disease
Brad Pasternak, Ashish Patel, Paul Tran, Lisa McMahon
Journal of Pediatric Gastroenterology and Nutrition.2023; 76(2): 137. CrossRef
Perioperative Assessment and Optimization in Major Colorectal Surgery: Medication Management
William J. Kane, Puja Shah Berry
Clinics in Colon and Rectal Surgery.2023; 36(03): 210. CrossRef
Which biologic agents increase perioperative complications in patients with inflammatory bowel disease?
Jihye Park
Intestinal Research.2022; 20(1): 1. CrossRef
Management of inflammatory bowel disease beyond tumor necrosis factor inhibitors: novel biologics and small-molecule drugs
Soo-Young Na, You Sun Kim
The Korean Journal of Internal Medicine.2022; 37(5): 906. CrossRef
Anti -TNFα agents in preventing the postoperative recurrence of Crohn’s disease: Do they still play a role in the biological era?
Caiguang Liu, Na Li, Shukai Zhan, Zhenyi Tian, Dongxuan Wu, Tong Li, Zhirong Zeng, Xiaojun Zhuang
Expert Opinion on Biological Therapy.2021; : 1. CrossRef

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Case Report

IBD

A case of ulcerative colitis presenting with cerebral venous thrombosis: Junghwan Lee, Sung Wook Hwang, Jinhee Lee, Kyung Hwa Jung, Ha Il Kim, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang; Intest Res 2018;16(2):306-311. Published online April 30, 2018; DOI: https://doi.org/10.5217/ir.2018.16.2.306

Abstract PDF PubReader ePub

Patients with inflammatory bowel disease (IBD) have been reported to have an increased risk of thromboembolism. Cerebral venous thrombosis (CVT) is a rare but serious extraintestinal manifestation of IBD. Due to its highly variable manifestation and low incidence, CVT is not usually readily recognized by physicians. Herein, we report a case of a 35-year-old male presenting with CVT associated with ulcerative colitis (UC). The patient was admitted with chief complaints of bloody diarrhea that had started 3 days prior. Sigmoidoscopy showed hyperemic and edematous mucosa, friability, and shallow ulcers from the sigmoid colon to the rectum suggestive of IBD. Three days later, the patient started complaining of a headache, and gradually developed a decreased level of consciousness. Magnetic resonance imaging of the brain revealed CVT with hemorrhagic infarctions. An angiogram was obtained to evaluate the extent of CVT, and anticoagulation therapy was initiated with intravenous heparin. During hospitalization, he was diagnosed with UC and treated with 5-aminosalicylic acid. After discharge, the patient was recovered without neurological deficit, and remission of UC was also obtained. The presence of headache or acute worsening of neurological status in a patient with IBD should alert the health professionals about the possibility of CVT.

Citations

Citations to this article as recorded by

Digit Necrosis After Hand Surgery in Pregnancy: A Case Report
Natalia Ziolkowski, Jana Dengler, Cory S Goldberg
Plastic Surgery Case Studies.2021;[Epub] CrossRef
Cerebral venous thrombosis as presenting manifestation of inflammatory bowel disease (IBD)
Katie Stamp, Alison Pattinson, Paul Maliakal, Thekootu Nandakumar, Shaji Sebastian
GastroHep.2019; 1(1): 45. CrossRef

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Original Article

Miscellaneous

A simple phenotypic classification for celiac disease: Ajit Sood, Vandana Midha, Govind Makharia, B. K. Thelma, Shivalingappa S Halli, Varun Mehta, Ramit Mahajan, Vikram Narang, Kriti Sood, Kirandeep Kaur; Intest Res 2018;16(2):288-292. Published online April 30, 2018; DOI: https://doi.org/10.5217/ir.2018.16.2.288

Abstract PDF PubReader ePub

Background/Aims

Celiac disease is a global health problem. The presentation of celiac disease has unfolded over years and it is now known that it can manifest at different ages, has varied presentations, and is prone to develop complications, if not managed properly. Although the Oslo definitions provide consensus on the various terminologies used in literature, there is no phenotypic classification providing a composite diagnosis for the disease.

Methods

Various variables identified for phenotypic classification included age at diagnosis, age at onset of symptoms, clinical presentation, family history and complications. These were applied to the existing registry of 1,664 patients at Dayanand Medical College and Hospital, Ludhiana, India. In addition, age was evaluated as below 15 and below 18 years. Cross tabulations were used for the verification of the classification using the existing data. Expert opinion was sought from both international and national experts of varying fields.

Results

After empirical verification, age at diagnosis was considered appropriate in between A1 (<18) and A2 (≥18). The disease presentation has been classified into 3 types–P1 (classical), P2 (non-classical) and P3 (asymptomatic). Complications were considered as absent (C0) or present (C1). A single phenotypic classification based on these 3 characteristics, namely age at the diagnosis, clinical presentation, and intestinal complications (APC classification) was derived.

Conclusions

APC classification (age at diagnosis, presentation, complications) is a simple disease explanatory classification for patients with celiac disease aimed at providing a composite diagnosis.

Citations

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Analyzing the landscape of coeliac crisis in adult and paediatric populations: A systematic review and meta-analysis
Arkadeep Dhali, Rick Maity, Hareesha Rishab Bharadwaj, Syed Hasham Ali, Muhammad Hamza Shah, David Surendran Sanders
Digestive and Liver Disease.2025; 57(6): 1149. CrossRef
Clinicopathologic Analysis of Malabsorption Syndrome in a Tertiary Care Center in South India
Nidhya Ganesan, S. Shrinnivi, R. Shivani, R. K. Kartikayan
Medical Journal of Dr. D.Y. Patil Vidyapeeth.2024; 17(3): 616. CrossRef
Prevalence of haplotype DQ2/DQ8 and celiac disease in children with type 1 diabetes
Agnieszka Zubkiewicz-Kucharska, Tatiana Jamer, Joanna Chrzanowska, Katarzyna Akutko, Tomasz Pytrus, Andrzej Stawarski, Anna Noczyńska
Diabetology & Metabolic Syndrome.2022;[Epub] CrossRef
Celiac crisis, a rare occurrence in adult celiac disease: A systematic review
Daniel Vasile Balaban, Alina Dima, Ciprian Jurcut, Alina Popp, Mariana Jinga
World Journal of Clinical Cases.2019; 7(3): 311. CrossRef
The spectrum of clinical and subclinical endocrinopathies in treatment-naïve patients with celiac disease
Vipin Gupta, Alka Singh, Rajesh Khadgawat, Ashish Agarwal, Asif Iqbal, Wajiha Mehtab, P.K. Chaturvedi, Vineet Ahuja, Govind K. Makharia
Indian Journal of Gastroenterology.2019; 38(6): 518. CrossRef

8,477 View
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Case Report

Cerebral venous thrombosis in a patient with Crohn's disease: Young-Hak Cho, Min Kyu Chae, Jae Myung Cha, Joung Il Lee, Kwang Ro Joo, Hyun Phil Shin, Il Hyun Baek, Jung Won Jeon, Jun Uk Lim, In Taik Hong, Hye-Jin Ki, Jae Bin Kang; Intest Res 2016;14(1):96-101. Published online January 26, 2016; DOI: https://doi.org/10.5217/ir.2016.14.1.96

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Patients with inflammatory bowel disease (IBD) have an elevated risk of venous thromboembolism compared with the general population. The most common sites of venous thromboembolism in IBD patients are the deep veins of the legs, the pulmonary system, and portal and mesenteric veins. However, cerebral venous thrombosis is rarely associated with IBD. This report describes a case of cerebral venous thrombosis in a patient with Crohn's disease. A 17-year-old girl, diagnosed 4 years earlier with Crohn's disease, presented with headache and vomiting. Magnetic resonance imaging of the brain with venography showed venous thrombosis in the cortical veins, superior sagittal sinus, right transverse sinus, and right internal jugular vein. The patient immediately started anticoagulation therapy with intravenous heparin infusion followed by daily oral rivaroxaban 10 mg. Follow-up imaging after 2 weeks showed resolution of the thrombosis, with recanalization of the cortical veins, superior sagittal sinus, right transverse sinus, and right internal jugular vein. She continued rivaroxaban therapy for 6 months, and remained well, without neurologic sequelae. A high level of concern for cerebral venous thrombosis may be important when treating active IBD patients, because anticoagulation treatment can prevent fatal complications.

Citations

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Cerebral venous thrombosis during relapse of ulcerative colitis: Case report with review of literature
S. Bouchal, B. Alami, N. Chtaou, M. Abkari, M. Maaroufi, F. Belahsen
JMV-Journal de Médecine Vasculaire.2021; 46(1): 22. CrossRef
Direct oral anticoagulants in treatment of cerebral venous thrombosis: a systematic review
Gauruv Bose, Justin Graveline, Vignan Yogendrakumar, Risa Shorr, Dean A Fergusson, Gregoire Le Gal, Jonathan Coutinho, Marcelo Mendonça, Miguel Viana-Baptista, Simon Nagel, Dar Dowlatshahi
BMJ Open.2021; 11(2): e040212. CrossRef
The Twists and Turns of Diagnosis and Treatment of Pediatric Neuro-Behcet's Disease: A Case Report and Literature Review
Qiao Zhang, Yizhen Luo, Jianli Zhou, Shaoming Zhou, Zhaoxia Wang
Frontiers in Pediatrics.2021;[Epub] CrossRef
Recurrent Unprovoked Venous Thrombosis (Cerebral Sinus Thrombosis and Mesenteric Vein Thrombosis) in Young Patient with Crohn’s Disease: A Case Report and Review
Abdullah Mohammed Albishi, Rafaat Chakik, Ali Saleh Alshamrani
Case Reports in Gastrointestinal Medicine.2020; 2020: 1. CrossRef
Use of direct oral anticoagulants in cerebral venous thrombosis: a systematic review
Sen Sheng, Krishina Nalleballe, Naga V. Pothineni, Rohan Sharma, Aliza Brown, Hisham Elkhider, Saritha Ranabothu, Nidhi Kapoor, Kelly-Ann Patrice, Sanjeeva Onteddu
Blood Coagulation & Fibrinolysis.2020; 31(8): 501. CrossRef
Direct oral anticoagulant use in patients with thrombophilia, antiphospholipid syndrome or venous thrombosis of unusual sites: A narrative review
Laurent Bertoletti, Ygal Benhamou, Yannick Béjot, Sylvestre Marechaux, Saida Cheggour, Boris Aleil, Nicolas Lellouche, Jean-Guillaume Dillinger, Aurélien Delluc
Blood Reviews.2018; 32(4): 272. CrossRef
A case of ulcerative colitis presenting with cerebral venous thrombosis
Junghwan Lee, Sung Wook Hwang, Jinhee Lee, Kyung Hwa Jung, Ha Il Kim, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang
Intestinal Research.2018; 16(2): 306. CrossRef
Rivaroxaban and Apixaban for Initial Treatment of Acute Venous Thromboembolism of Atypical Location
Dawid T. Janczak, Malgorzata K. Mimier, Robert D. McBane, Patrick S. Kamath, Benjamin S. Simmons, Dalene M. Bott-Kitslaar, Charles J. Lenz, Emily R. Vargas, David O. Hodge, Waldemar E. Wysokinski
Mayo Clinic Proceedings.2018; 93(1): 40. CrossRef
Use of Novel Oral Anticoagulant to Treat Pulmonary Thromboembolism in Patient with Ulcerative Colitis Superinfected Cytomegalovirus Colitis
Seok-Hwan Kim, Sunhee Jang, Yegyu Sung, Jun Kyu Park, Yunjung Park, Jintak Yun, Sang-Bum Kang
The Korean Journal of Gastroenterology.2017; 70(1): 44. CrossRef

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Original Article

Risk Factors for Delayed Post-Polypectomy Bleeding: Min Jung Kwon, You Sun Kim, Song I Bae, Young Il Park, Kyung Jin Lee, Jung Hwa Min, Soo Yeon Jo, Mi Young Kim, Hye Jin Jung, Seong Yeon Jeong, Won Jae Yoon, Jin Nam Kim, Jeong Seop Moon; Intest Res 2015;13(2):160-165. Published online April 27, 2015; DOI: https://doi.org/10.5217/ir.2015.13.2.160

Abstract PDF PubReader

Background/Aims

Among the many complications that can occur following therapeutic endoscopy, bleeding is the most serious, which occurs in 1.0-6.1% of all colonoscopic polypectomies. The aim of this study was to identify risk factors of delayed post-polypectomy bleeding (PPB).

Methods

We retrospectively reviewed the data of patients who underwent colonoscopic polypectomy between January 2003 and December 2012. We compared patients who experienced delayed PPB with those who did not. The control-to-patient ratio was 3:1. The clinical data analyzed included polyp size, number, location, and shape, patient' body mass index (BMI), preventive hemostasis, and endoscopist experience.

Results

Of 1,745 patients undergoing colonoscopic polypectomy, 21 (1.2%) experienced significant delayed PPB. We selected 63 age- and sex-matched controls. Multivariate logistic regression analysis showed that polyps >10 mm (odds ratio [OR], 2.605; 95% confidence interval [CI], 1.035-4.528; P=0.049), a pedunculated polyp (OR, 3.517; 95% CI, 1.428-7.176; P=0.045), a polyp located in the right hemicolon (OR, 3.10; 95% CI, 1.291-5.761; P=0.013), and a high BMI (OR, 3.681; 95% CI, 1.876-8.613; P=0.013) were significantly associated with delayed PPB.

Conclusions

Although delayed PPB is a rare event, more caution is needed during colonoscopic polypectomies performed in patients with high BMI or large polyps, pedunculated polyps, or polyps located in the right hemicolon.

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