Right atrium floating thrombus and bilateral pulmonary embolism in a patient with pancreatic pseudocyst

Cherata, D.A.; Donoiu, I; Mirea, Oana; Diaconu, Rodica; Istrătoaie, Octavian

doi:10.1016/j.jccase.2018.04.006

Cited by 2 publications

(2 citation statements)

References 10 publications

(10 reference statements)

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“…In a study by Cherata et al, a case was reported involving a patient with a pancreatic pseudocyst who presented with a right atrium floating thrombus and bilateral pulmonary embolism, mimicking a cardiac condition. This case highlighted the potential for pancreatic pseudocysts to mimic other serious medical conditions, emphasizing the importance of accurate diagnosis and appropriate management [10].…”

Section: Discussionmentioning

confidence: 97%

Rupture of a Huge Pancreatic Pseudocyst in a Superobese Patient: A Condition Mimicking Pulmonary Embolism

Suleimanov,

Naser,

Al-Taweel

2023

Cureus

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Pancreatic pseudocysts are fluid-filled collections that can arise from acute or chronic pancreatitis and may lead to a range of complications, like rupture, infection, hemorrhage, etc. Morbid obesity may further complicate the diagnosis and management of such cases. The present report describes the case of a 26-yearold superobese female (BMI: 58 kg/m²) with a pancreatic pseudocyst that presented diagnostic challenges and mimicked pulmonary embolism when the pseudocyst had ruptured. The patient initially presented with persistent biliary colic due to gallstones. Despite undergoing laparoscopic cholecystectomy, she continued to experience symptoms, including nausea, bloating, and inability to tolerate food, and lab tests showed progressive elevation of serum bilirubin levels. A huge pancreatic pseudocyst was found to be obliterating the gastric cavity and compressing the common bile duct after the patient was subjected to further radiological imaging. While waiting to be transferred to a tertiary center with endoscopic retrograde cholangiopancreatography (ERCP), endoscopic stenting, and other facilities, she suddenly experienced severe symptoms, like shortness of breath, upper abdominal/chest pain, tachycardia (heart rate: 140 beats per min), dizziness, and low oxygen saturation. The likelihood of pulmonary embolism (PE) was very high in the differential diagnoses, but computer tomography pulmonary angiography (CTPA) ruled out PE. Based on imaging and clinical assessment, rupture of the pancreatic pseudocyst was diagnosed. The patient was subsequently managed in a tertiary hospital endoscopically. This case highlights the challenges of diagnosing and managing pancreatic pseudocysts in extremely obese patients. It also underscores the role of a multidisciplinary approach and vigilant clinical attention to prevent misdiagnosis and optimize outcomes.

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Section: Discussionmentioning

confidence: 97%

Rupture of a Huge Pancreatic Pseudocyst in a Superobese Patient: A Condition Mimicking Pulmonary Embolism

Suleimanov,

Naser,

Al-Taweel

2023

Cureus

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“…This is confirmed by the fact that angiotensinogen-converting enzyme-2 receptor on the pancreatic islet cells acts as a receptor for severe acute respiratory syndrome-coronavirus-2 (SAR-CoV2) to bind and, as a result, invasion of the gland is possible as the virus can spread from the duodenal epithelium to the pancreatic duct and then to the acinar and islet cells [ 6 , 7 ]. Furthermore, pancreatic inflammation is related to a prothrombotic condition and endothelial dysfunction, all of which facilitate and accelerate atherothrombosis growth [8] .…”

Section: Discussionmentioning

confidence: 99%

Left ventricular thrombus with normal systolic function secondary to the novel prothrombotic association of acute on chronic calcific pancreatitis and COVID-19

Jariwala

Jadhav

Aurangabadkar

et al. 2022

Journal of Cardiology Cases

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In the presence of normal left ventricular systolic function, the development of left ventricular thrombus has seldom been documented in hypercoagulable conditions. Echocardiographic results of left ventricular thrombi can be differentiated from those found in cardiac tumors such as myxoma. Many other organs, including the central and peripheral nervous systems, as well as the cardiac and vascular systems, have recently been linked to thromboembolic events in coronavirus disease 2019 . It not only exacerbates acute pancreatitis but often predisposes, in fact, to a novel prothrombotic state in patients with pre-existing comorbid conditions such as chronic calcific pancreatitis. We report an unusual correlation of two prothrombotic disorders -COVID-19 and acute on chronic pancreatitis contributing to the development of thrombus in a normal left ventricle.

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Right atrium floating thrombus and bilateral pulmonary embolism in a patient with pancreatic pseudocyst

Cited by 2 publications

References 10 publications

Rupture of a Huge Pancreatic Pseudocyst in a Superobese Patient: A Condition Mimicking Pulmonary Embolism

Rupture of a Huge Pancreatic Pseudocyst in a Superobese Patient: A Condition Mimicking Pulmonary Embolism

Left ventricular thrombus with normal systolic function secondary to the novel prothrombotic association of acute on chronic calcific pancreatitis and COVID-19

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