Role of Inflammatory Bowel Disease in Pulmonary Embolism

Running head: CASE STUDY
CASE STUDY
Name of the Student
Name of University
Author’s note

CASE STUDY
Introduction
Inflammatory bowel disease (IBD) is defined as a group of inflammatory situation of the
small intestine and the colon. The Crohn’s disease (CD) and ulcerative colitis (UC) are two
different types of idiopathic IBD that is presented with chronic progressive and relapsing
inflammation affecting the entire gastrointestinal tract and colonic mucosa respectively (Loddo
& Romano, 2015). Pulmonary embolism (PE) is a life threatening condition that involves
embolic and thrombotic occlusion of the pulmonary arterial system (Piazza, Hohlfelder &
Goldhaber, 2015). The case study of choice (case study 8) represents a 33-year old man with
previous history of IBD and at present suspected with PE. The following paper will help to
answer one question in relation to the pathophysiology highlighted in the selected case study.
The paper will initiate with the selected research question followed by the hypothesis and a
critical discussion of two peered reviewed journals in order to answer the question of choice.
Question
What is the role of active inflammatory bowel disease in the development of pulmonary
embolism?
Hypothesis
The presence of IBD for a prolong period of time increases the vulnerability of
developing pulmonary embolism. The IBD lead to inflammation, hampering the normal process
of secretion of cytokines and coagulation factor. Hamper in the equilibrium of the coagulation
factor leads to the development of pulmonary embolism.

CASE STUDY
Discussion
In the case study the patient has a previous reported case of IBD. The clinical
presentation of IBD includes passage of pus or mucus, bloody diarrhoea and abdominal pain
(Loddo & Romano, 2015). In the case study, the 33-year old man was diagnosed with UC 4
years before and was present to the primary healthcare physicians with chronic diarrhoea,
extreme weight loss and anaemia arising from iron-deficiency. The thrombotic occlusion during
pulmonary embolism (PE) mainly occurs due to the development of deep vein thrombosis
(DVT). DVT is defined as the formation of blood clot in more than one deep vein. The
formations of progressive clots results in clot to break loose from the walls of the veins. The clot
then travels through the blood stream of the veins and lodge in the lungs resulting in the
development of PE. This is the reason why PE is popularly known as pulmonary
thromboembolism (Piazza, Hohlfelder & Goldhaber, 2015). The clotting in the lungs might be
responsible for symptoms displayed by the 33-year old man in the case study like pain in right
chest, increase in pain during inspiration while lying down.
Chung Lin, Hsu and Kao (2015) reported that IBD related with the chronic inflammation
might increase the vulnerability of developing PE and DVT however, there are poor
epidemiological evidences suggesting their relationships. Thus in order to address this concern,
Chung Lin, Hsu and Kao (2015) conducted a longitudinal nationwide cohort study in the Taiwan
healthcare field. The analysis of the results showed that the risk of DVT and PE are significantly
higher in the population that is suffering from IBD for a prolong period of time in comparison to
the general population. The underlying pathophysiology for this is highlighted as follows. Chung
Lin, Hsu and Kao (2015) are of the opinion that basic mechanism of thromboembolism includes
formation of hypercoagulability along with generation of endothelial dysfunction as represented