Vascular complications of pancreatitis

Mendelson, Richard; Anderson, James M.; Marshall, Martin; Ramsay, Duncan

doi:10.1111/j.1445-2197.2005.03607.x

Cited by 105 publications

(100 citation statements)

References 24 publications

(34 reference statements)

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“…They are usually detected within 3 to 5 weeks following the onset of an acute episode of pancreatitis, but hemorrhage can occur from a few days to several years after an attack of pancreatitis [11]. Acute hemorrhage from a pseudoaneurysm is the most rapidly fatal complication of chronic pancreatitis.…”

Section: Discussionmentioning

confidence: 99%

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Ruptured Pancreaticoduodenal Artery Pseudoaneurysm with Chronic Pancreatitis Presenting as Recurrent Upper Gastrointestinal Bleeding

et al. 2007

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Section: Discussionmentioning

confidence: 99%

“…Bleeding episodes can occur infrequently over a period of months to years or may happen in rapid succession. Sites of rupture include the duodenum, common bile duct, and colon, while less commonly, they may rupture into the peritoneal cavity or retroperitoneum [5,10,11].…”

Section: Discussionmentioning

confidence: 99%

Ruptured Pancreaticoduodenal Artery Pseudoaneurysm with Chronic Pancreatitis Presenting as Recurrent Upper Gastrointestinal Bleeding

et al. 2007

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“…A palpable lump in case of AP is usually due to an inflammatory mass or a collection. The presence of pancreatic or peri-pancreatic collection and inflammation has been postulated as a cause of SVT [4,11]. Pleural effusion was also seen in a significantly greater number of patients with SVT, which may be related to a higher degree of local inflammation in AP patients with pleural effusion.…”

Section: Discussionmentioning

confidence: 99%

“…Factors that have been implicated are pancreatic and peripancreatic edema, inflammatory cellular infiltration, direct injury to blood vessels and fluid collection compressing the vessels and causing stasis of blood flow. Peri-pancreatic inflammatory changes or fluid collecstions create a milieu that promotes the development of SVT [9,11].…”

Section: Introductionmentioning

confidence: 99%

Role of Thrombophilia in Splanchnic Venous Thrombosis in Acute Pancreatitis

Ahmed¹,

Rana²,

Ahluwalia³

et al. 2017

Gastroenterology

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“…Vascular complications of pancreatitis are a poorly understood but commonly described phenomenon (4,5). Venous thrombosis, a known complication of acute pancreatitis, most commonly involves the portal, splenic and splanchnic veins (5,6) Much less commonly, extrasplanchnic involvement has been reported in the pulmonary vasculature (2,3,7), renal vein (2,8,9), and in a remarkable case, multiple sites including the superior and inferior vena cavae, bilateral subclavian veins, internal jugular and iliac veins (10).…”

Section: Discussionmentioning

confidence: 99%

Pulmonary embolism and acute pancreatitis: Case series and review

Deiss

Young²,

Yeh³

et al. 2020

Turk J Gastroenterol

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Reports of pulmonary embolism in the setting of acute pancreatitis are rare. We present three cases of acute pancreatitis associated with pulmonary embolism and review the literature. Two of the three patients had severe acute pancreatitis with bilateral pulmonary emboli, and to our knowledge, these cases represent the first report of pulmonary embolism occurring in the setting of pancreatic ascites and pleural effusion. All patients experienced abdominal pain, though in one patient, symptoms suggestive of a pulmonary embolism were lacking. All three patients were successfully treated with unfractionated heparin and conservative management. Pulmonary thrombosis may occur in the setting of severe acute pancreatitis as the result of systemic inflammatory response. We review the literature and provide microvascular explanations for the occurrence of pulmonary complications and thrombosis in the setting of acute pancreatitis. We also review prior cases of pulmonary embolism in acute pancreatitis. Our experience suggests that pulmonary embolism may be an under-recognized complication of severe acute pancreatitis. Keywords: Pulmonary embolism, pancreatitis, ascites, pleural effusion, thrombosis INTRODUCTIONSevere acute pancreatitis can provoke a systemic inflammatory response which may lead to a number of vascular and pulmonary complications. Pulmonary embolism is a rarely reported complication of acute pancreatitis (1-3). Here we present three cases of acute pancreatitis associated with pulmonary embolism, and propose that pulmonary vascular thrombosis may be an underrecognized complication of severe acute pancreatitis. To our knowledge, two of the three cases represent the first reports of pulmonary embolism occurring in the setting of pancreatic ascites and pleural effusion. CASE PRESENTATIONSCase 1 A 28 year old woman presented with six weeks of abdominal pain along with nausea and vomiting. The patient had a history of alcoholic pancreatitis but denied recent alcohol consumption. She reported no chest pain or shortness of breath. Initial vital signs included a temperature of 98.7 F, blood pressure of 122/87 mmHg, and she was tachycardic with a heart rate of 132 beats/ min. Oxygen saturation was 95% on room air. Physical examination was remarkable for epigastric tenderness and abdominal distention consistent with ascites. Lipase was 1,453 IU/L, and liver enzymes were normal. Ascitic fluid analysis showed an amylase of 43,400 IU/L. CT scan of the abdomen and pelvis showed ascites and evidence of prior cholecystectomy. Incidental, multiple pulmonary emboli were seen in bilateral lower lobes, along with a right-sided pleural effusion and lower lobe consolidation with abnormal enhancement, consistent with pulmonary infarct (Figure 1). The pancreas appeared normal.The patient was started on unfractionated heparin along with intravenous hydration and bowel rest. Her abdominal pain and nausea quickly improved, and she tolerated an oral diet within three days. She was discharged with low-molecular weight heparin a...

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Vascular complications of pancreatitis

Cited by 105 publications

References 24 publications

Ruptured Pancreaticoduodenal Artery Pseudoaneurysm with Chronic Pancreatitis Presenting as Recurrent Upper Gastrointestinal Bleeding

Ruptured Pancreaticoduodenal Artery Pseudoaneurysm with Chronic Pancreatitis Presenting as Recurrent Upper Gastrointestinal Bleeding

Role of Thrombophilia in Splanchnic Venous Thrombosis in Acute Pancreatitis

Pulmonary embolism and acute pancreatitis: Case series and review

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