Bilateral pulmonary embolism and pulmonary infarctions in active ulcerative colitis

BMJ Case Rep. 2022 Mar 9;15(3):e249428. doi: 10.1136/bcr-2022-249428.

Brittany Bromfield 1, Marc Schwartz 2


Author information

1Internal Medicine, UPMC, Pittsburgh, Pennsylvania, USA bromfieldbb@upmc.edu.

2Gastroenterology and Hepatology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.


Crohn's disease and ulcerative colitis are inflammatory bowel diseases (IBDs) and they primarily involve the intestines and confer an increased risk of thromboembolism (TE). Here we report a case of a young man with active ulcerative colitis (UC) who presented with shortness of breath and syncope. He was found on imaging to have an extensive bilateral pulmonary embolism (PE) and right heart strain with associated pulmonary infarctions. The patient was initially managed with a heparin infusion and subsequently transitioned to a direct acting oral anticoagulant (DOAC) with clinical improvement in his symptoms.

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