Chronic Pancreatitis-Induced Thrombosis of Celiac and Superior Mesenteric Artery.

Journal of medical cases Pub Date : 2023-10-01 Epub Date: 2023-10-13 DOI:10.14740/jmc4112
Harshavardhan Sanekommu, Sobaan Taj, Rida Mah Noor, Muhammad Umair Akmal, Claudia Ramirez, Pranav Shah, Mohammad Hossain, Asif Arif
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Abstract

Every year, nearly 60,000 hospitalizations occur in the United States due to chronic pancreatitis (CP). CP can cause severe chronic abdominal pain, pancreatic insufficiency, and increased risk of pancreatic cancer. While venous thrombotic complications are common, arterial thrombotic events are rarely reported in CP. This report describes a case of a 43-year-old female who presented with severe worsening abdominal pain due to CP. Diagnostic imaging disclosed thrombosis of superior mesenteric artery (SMA) and celiac artery (CA) with acute bowel wall changes reflecting ischemic changes, resulting in acute-on-chronic mesenteric ischemia. Endovascular stent placement relieved the ischemia with the resolution of pain. Arterial thrombosis should be considered as a diagnostic possibility when patients with CP present with a significant change in symptoms. Importantly, the case demonstrates that endovascular treatment with stent placement can relieve ischemia and resolve symptoms in patients with CP.

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慢性胰腺炎引起腹腔和肠系膜上动脉血栓形成。
美国每年有近6万人因慢性胰腺炎住院。CP可引起严重的慢性腹痛、胰腺功能不全,并增加胰腺癌症的风险。虽然静脉血栓性并发症很常见,但动脉血栓性事件在CP中很少报道。本报告描述了一例43岁的女性,她因CP而出现严重恶化的腹痛。诊断成像揭示了肠系膜上动脉(SMA)和腹腔动脉(CA)的血栓形成,并伴有反映缺血变化的急性肠壁变化,导致急性至慢性肠系膜缺血。血管内支架置入术缓解了局部缺血,减轻了疼痛。当CP患者出现明显症状变化时,应将动脉血栓形成视为一种诊断可能性。重要的是,该病例表明,支架置入的血管内治疗可以缓解CP患者的缺血和症状。
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