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- W2327280708 abstract "Introduction: Thrombosis is a known complication of acute and chronic pancreatitis affecting up to 14% of these patients. The splenic and portal veins represent the most frequently affected sites; however, thrombosis of unusual locations such as the subclavian, cava and jugular veins has been reported. Increased resistance to flow through the splanchnic circulation can lead to important complications including gastrointestinal bleeding, ascites, and encephalopathy. We report a patient presenting with extensive, acute thrombosis of the splanchnic circulation. Case report: A 37-year-old male patient with a history of alcoholism was admitted following a 4-day history of nausea, vomiting and right abdominal pain. Physical examination revealed upper abdominal tenderness, an enlarged liver and a palpable spleen. Abdominal computed tomography showed severe inflammation of an already calcified and atrophic pancreas. There was thrombosis of the splenomesaraic confluence extending to the portal, splenic and superior mesenteric veins. There was also complete occlusion of the right portal branch and partial occlusion of the left. The patient was started on analgesics, antibiotics and parenteral anticoagulation. Endoscopy revealed incipient esophageal varices. Tumor markers were negative. Investigation for inherited or acquired prothrombotic factors revealed elevated levels of homocysteine. The patient was discharged on oral anticoagulation and referred to a gastroenterology consult. Discussion: Review of the available literature describes an association between pancreatitis and pro-thrombotic phenomena. The underlying mechanism may result from endothelial injury secondary to systemic inflammation, down-regulation of antithrombotic and fibrinolytic cascades or disseminated intravascular coagulation. The risk appears to be higher in acute versus chronic pancreatitis (23 versus 12%), suggesting a hypothetical association with the degree of inflammation. Clinicians should be aware of this important and potentially fatal, cause of portal hypertension." @default.
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- W2327280708 date "2013-10-01" @default.
- W2327280708 modified "2023-10-16" @default.
- W2327280708 title "Chronic pancreatitis associated with extensive splanchnic thrombosis" @default.
- W2327280708 doi "https://doi.org/10.1016/j.ejim.2013.08.196" @default.
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