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Dawra S, Hasvi J, Srivastava S, Bhanu U, Chandra A. Renal vein thrombosis in pancreatitis: a rare vascular complication. Med J Armed Forces India 2023; 79:S348-S351. [PMID: 38144657 PMCID: PMC10746828 DOI: 10.1016/j.mjafi.2022.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 04/17/2022] [Indexed: 11/18/2022] Open
Abstract
Extrasplanchnic venous thrombosis is a rare complication of chronic pancreatitis. Thrombosis of inferior vena cava and renal vein, in particular, is extremely rare. We present our recent experience of managing two patients of chronic pancreatitis who presented with renal vein thrombosis. We also highlight the treatment dilemmas facing a clinician managing patients with this atypical and rare vascular complication.
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Affiliation(s)
- Saurabh Dawra
- Classified Specialist (Gastroenterology), Command Hospital (Southern Command), Pune, India
| | - Jayaraj Hasvi
- Resident (Medicine), Command Hospital (Southern Command), Pune, India
| | - Sharad Srivastava
- Senior Adviser (Medicine) & Gastroenterologist, Command Hospital (Southern Command), Pune, India
| | - Uday Bhanu
- Professor, Department of Radiodiagnosis & Imaging, Armed Forces Medical College, Pune, India
| | - Alok Chandra
- Consultant (Gastroenterology), Command Hospital (Southern Command), Pune, India
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Alagappan A, Sahoo B, Panigrahi MK, Sidhu S. Gastric perforation and renal vein thrombosis in acute pancreatitis: a case report. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2022. [DOI: 10.1186/s43055-022-00890-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Acute pancreatitis is one of the most common causes of acute abdomen. It is associated with multiple complications. Gastric perforation and isolated renal vein thrombosis are two infrequent complications. We present a case of acute pancreatitis with gastric perforation and isolated renal vein thrombosis in the same patient.
Case presentation
A 28-year-old gentleman with chronic alcohol intake presented with complaints of abdominal pain and not responding to analgesics. Biochemical investigations revealed elevated amylase and lipase level. Contrast-enhanced computed tomography (CECT) showed necrotizing pancreatitis with necrotic collection in the lesser sac. On oral contrast, active contrast extravasation from gastric perforation was picked up. Renal vein and splenic vein thrombosis was observed.
Conclusions
Gastric perforation and renal vein thrombosis are two infrequent complications of acute pancreatitis. High-end radiological suspicion is needed to reduce the associated morbidity and mortality.
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Parmeshwar Ramesh J, Sanjay C, Udgirkar S, Sujit N, Prasanta D, Ammar M, Partha D, Shubham J, Thanage R, Pravin R, Qais C. Multiple extra-splanchnic venous thromboses - an unusual vascular complication of acute pancreatitis. Clin Pract 2020; 10:1226. [PMID: 33072246 PMCID: PMC7533600 DOI: 10.4081/cp.2020.1226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Accepted: 09/11/2020] [Indexed: 11/23/2022] Open
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.
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Affiliation(s)
- Junare Parmeshwar Ramesh
- Department of Gastroenterology, Topiwala National Medical College and B.Y.L. Nair Charitable Hospital, Mumbai, India
| | - Chandnani Sanjay
- Department of Gastroenterology, Topiwala National Medical College and B.Y.L. Nair Charitable Hospital, Mumbai, India
| | - Suhas Udgirkar
- Department of Gastroenterology, Topiwala National Medical College and B.Y.L. Nair Charitable Hospital, Mumbai, India
| | - Nair Sujit
- Department of Gastroenterology, Topiwala National Medical College and B.Y.L. Nair Charitable Hospital, Mumbai, India
| | - Debnath Prasanta
- Department of Gastroenterology, Topiwala National Medical College and B.Y.L. Nair Charitable Hospital, Mumbai, India
| | - Modi Ammar
- Department of Gastroenterology, Topiwala National Medical College and B.Y.L. Nair Charitable Hospital, Mumbai, India
| | - Debnath Partha
- Department of Gastroenterology, Topiwala National Medical College and B.Y.L. Nair Charitable Hospital, Mumbai, India
| | - Jain Shubham
- Department of Gastroenterology, Topiwala National Medical College and B.Y.L. Nair Charitable Hospital, Mumbai, India
| | - Ravi Thanage
- Department of Gastroenterology, Topiwala National Medical College and B.Y.L. Nair Charitable Hospital, Mumbai, India
| | - Rathi Pravin
- Department of Gastroenterology, Topiwala National Medical College and B.Y.L. Nair Charitable Hospital, Mumbai, India
| | - Contractor Qais
- Department of Gastroenterology, Topiwala National Medical College and B.Y.L. Nair Charitable Hospital, Mumbai, India
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