Extended Venous Thromboembolism Prophylaxis After Surgery for Inflammatory Bowel Diseases

Surgical patients with inflammatory bowel disease (IBD) bring unique risk factors for venous thromboembolism (VTE), including Virchow’s triad of inflammation-associated hypercoagulability, stasis (ex. bed-rest from fatigue between frequent trips to the bathroom, prolonged operations), and the obvious trauma of surgery [1–3]. In this population, we are all aware that VTE includes not only lower extremity deep vein thrombosis (DVT) and pulmonary embolism (PE), but for IBD patients we must also keep in mind upper-extremity DVT related to central access for enteral nutrition, post-operative portomesenteric vein thrombosis (PMVT), and rarely cerebral venous sinus thrombosis [4, 5]. All of these can present silently or symptomatically, both before and after surgery.