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Citation: Medhioub F. Acute Pancreatitis: Prognosis of Vascular Complications.Jr.med.res.2022;5(1): 18-19. Medhioub © All rights are reserved.

https://doi.org/10.32512/jmr.5.1.2022/18.19 Submit your manuscript: www.jmedicalresearch.com

Images in clinical practice

Medhioub Fatma

Acute Pancreatitis: Prognosis of Vascular Complications.

1: College of medicine Tunis, Tunisia.

* Corresponding author

Correspondence to:

f.medhioub@gmail.com

Publication Data:

Submitted: January 31,2022

Accepted: March 28,2022

Online: June 30,2022

This article was subject to full peer-review.

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Case 1

A 61-year-old female was admitted for confirmed acute

pancreatitis. Abdominal CT revealed peripancreatic fat

infiltration and fluid collections. The patient developed a

septic syndrome on the second week. CT scan showed a

newly developed aneurysm dilatation of the anterior

segmental right artery and a thrombosis of the right

portal branch (Figure1). Aneurysm embolization was

performed successfully (Figure2).

Case 2

A 28-year-old male with no history, was admitted for

severe acute biliary pancreatitis. The cholecystectomy

was postponed. He presented six month later with

pancreatitis recrudescence. Abdominal CT scan showed

acute pancreatitis with fluid collections and right portal

vein thrombosis (Figure3). Anticoagulant treatment was

prescribed. The cholecystectomy was done after portal

vein permeabilization (Figure4).

Acute Pancreatitis: Prognosis of Vascular Complications

Citation: Medhioub F. Acute Pancreatitis: Prognosis of Vascular Complications.Jr.med.res.2022;5(1): 18-19. Medhioub © All rights are reserved.

Submit your manuscript: www.jmedicalresearch.com

Comments

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. Vascular abnormalities are commonly seen in late-stage acute pancreatitis and chronic pancreatitis.

However, only few reports studied vascular involvement occurring in the early phase of the disease [1]. extra-

splanchnic venous system thrombosis as well as arterial system are rarely described [2]. Vascular complications are

more frequent in necrotizing acute pancreatitis [3]. These complications are underdiagnosed, which may justify the

systematic MRI assessment of AP cases [4]. Vascular complications are prognostic indicators of pancreatitis severity

[5].

Conflict of Interest: None

References

[1] Ahmed M, Aziz MU, Mansoor MA, Anwar S. Vascular complications in cases of acute pancreatitis - CT scan-based study. J Pak Med Assoc. 2016;66:977-89.

[2] Parmeshwar Ramesh J, Sanjay C, Udgirkar S, Sujit N, Prasanta D, Ammar M, et al. Multiple extra-splanchnic venous thromboses - an unusual vascular

complication of acute pancreatitis. Clin Pract. 2020 ;10:1226.

[3] Dike CR, Cress G, Fishman DS, Gonska T, Ooi CY, Perito ER, et al. Vascular Complications in Pediatric Pancreatitis: A Case Series. J Pediatr Gastroenterol Nutr.

2021;73:e94-e97.

[4] Jiang ZQ, Xiao B, Zhang XM, Xu HB. Early-phase vascular involvement is associated with acute pancreatitis severity: a magnetic resonance imaging study. Quant

Imaging Med Surg. 2021;11:1909-20.

[5] Vujasinovic M, Dugic A, Nouri A, Brismar TB, Baldaque-Silva F, Asplund E, et al. Vascular Complications in Patients with Chronic Pancreatitis. J Clin Med. 2021

;10:3720.