Chronic gastrointestinal inflammation and cerebrovascular events

335 ARTICLE SUMMARIES Ghali et al, from the University of Calgary, Alberta, reported a cross-Canada study of in-hospital stroke and death complicating carotid endarterectomy. Patients with a diagnosis of peptic ulcer disease (PUD) at the time of admission were found to have a higher likelihood of sustaining a stroke that those without PUD (10.3% versus 4.1%, P=0.022). Multivariate analysis adjusting for age, urgency of admission and medical comorbidity resulted in an odds ratio of 2.12 for stroke in patients with PUD. Keene et al reported three pediatric cases in which a cerebral vascular complication resulted from active ulcerative colitis. The first patient was a five-year-old boy with extensive brain infarction due to intracranial venous stasis or thrombosis. The second patient was a 13-year-old girl with widespread ischemic cerebral injury immediately following a subtotal colectomy. The third patient was a 12year-old boy with sagittal sinus thrombosis. The case report literature is reviewed and current theories of thrombogenesis in inflammatory bowel disease (IBD) are summarized below.