Inflammatory bowel disease

Abstract

In their comprehensive clinical review of inflammatory bowel disease, Daniel Baumgart and William Sandborn1Baumgart DC Sandborn WJ Inflammatory bowel disease: clinical aspects and established and evolving therapies.Lancet. 2007; 369: 1641-1657Summary Full Text Full Text PDF PubMed Scopus (1368) Google Scholar discuss the extraintestinal manifestations of Crohn's disease. However, the aorta was not listed as a possible site of involvement. The aortitis of Crohn's disease can involve the entire aorta: the aortic valve leaflets (aortic regurgitation), the aortic root (aneurysm), the aortic arch (aneurysm, chronic occlusion), and aortic branches (aneurysm, occlusion). Focal segments of the aortic wall can also be involved, causing aortic mural thrombus with or without secondary embolisation.2Novacek G Haumer M Schima W et al.Aortic mural thrombi in patients with inflammatory bowel disease; report of two cases and review of the literature.Inflamm Bowel Dis. 2004; 10: 430-435Crossref PubMed Scopus (59) Google Scholar, 3Ozsoyler I Yilik L Bozok S et al.Cardiovascular involvement in Crohn's disease in the absence of ankylosing spondylitis.Heart Vessels. 2005; 20: 164-166Crossref PubMed Scopus (11) Google Scholar, 4Pepperr C Munsch C Sivananthan UM et al.Unruptured aneurysm of the left sinus of Valsalva extending into the left ventricular outflow tract: presentation and imaging.Heart. 1998; 80: 1910-1993Google Scholar Furthermore, it is important to exclude Takayasu's arteritis since this disorder can be associated with Crohn's disease.5Biagi P Castro R Campanella G et al.Takayasu's arteritis and Crohn's disease: an unusual association. Report on two cases.Dig Liver Dis. 2001; 33: 487-491Summary Full Text PDF PubMed Google Scholar Suggestive features of Takayasu's arteritis include pulse deficits, arterial bruits, and a characteristic arteriogram or typical histology (granulomatous necrotising inflammation of the arterial wall). The aortitis of Crohn's disease can thus lead to aortitis with important management consequences beyond those of the main disease. It could necessitate advanced medical, endovascular, or surgical treatment of the aorta, depending on the site and severity of involvement. I declare that I have no conflict of interest.