Extra-splanchnic vascular thrombosis in pancreatic ascites: a case series
Keywords:Pancreatic ascites, Pulmonary thrombosis, Extra splanchnic vascular thrombosis
Pancreatic ascites is a dreaded complication of acute or chronic pancreatitis. It’s a therapeutic challenge with its effect on nutrition and the associated complications. Pancreatic ascites can lead to formation of pseudo aneurysm by direct erosion of vessel, but extra splanchnic vascular complications are rare. In this series of 5 cases, we report an unusual incidence of extra splanchnic vascular complications in cases of pancreatic ascites. Out of the 21 cases of pancreatic ascites treated over a period of 2 years (February 2021 to February 2023) in our centre, we encountered 5 cases with vascular complications in the extra splanchnic circulatory system like pulmonary, cerebral, and cardiac. All these cases didn’t show a thrombus in IVC or leg veins in Doppler study. Among these 5 patients, three succumbed to the complications. This highlights the need of targeted evaluation for thrombosis in systemic circulation, especially pulmonary circulation for all patients of pancreatic ascites. Though a causal association cannot be proved by this report, the increased incidence of pulmonary thrombosis in pancreatic ascites patients need further evaluation and work up and detailed analysis. Targeted evaluation and urgent treatment in the form of anticoagulation along with surgical or endoscopic treatment of pancreatic leak may halt the ongoing pro coagulation cascade.
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