Abstract
Acute pancreatitis (AP) is an acute inflammatory process of the pancreas with variable clinical presentations. Splanchnic venous thrombosis is a well-known vascular complication of AP and commonly present as thrombosis of the splanchnic venous system: splenic vein (SplV), portal vein (PV) and superior mesenteric vein (SMV), either separately or in combinations. Involvement of extra-splanchnic vessels is rare and associated with morbidity and mortality. Vascular complications are late phenomena and usually associated with local complications of AP, namely acute fluid collections, necrotizing pancreatitis and walled-off pancreatic necrosis. Pathogenesis of venous thrombosis is multifactorial in which pancreatic inflammation and systemic inflammatory response play a key role. At present, there are no consensus guidelines on treatment and use of anticoagulation for venous thrombosis in the setting of AP. Limited literature suggests the use of anticoagulation in presence of PV with or without SMV thrombosis and extrasplanchnic vessel involvement. Literature on extra-splanchnic vessels involvement in acute pancreatitis is sparse. Here we present two cases with multiple extra-splanchnic vessels involvement and their management.
Highlights
Acute pancreatitis (AP) is an acute inflammatory process of the pancreas with variable clinical presentations
We further evaluated the patient with blood investigations and contrast enhanced computed tomography scan (CECT) of abdomen and chest
Complications are well known in AP and commonly present as thrombosis of the protein C and S, antithrombin III, factor V Leiden, JAK 2 mutation, homocysteine and
Summary
Acute pancreatitis (AP) is an acute inflammatory process of the pancreas with variable clinical presentations. Patient without SMV thrombosis and extra- ing about 8.4×4.2×5.2 cm which extended improved symptomatically and was dissplanchnic vessel involvement. Literature on extra-splanchnic vessels involvement in acute pancreatitis is sparse.
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