Schattner Ami, Klepfish Avraham, Huszar Monica, Shani Adi
Department of Medicine , Kaplan Medical Center, Rehovot, Israel.
Am J Med Sci. 2002 Dec;324(6):335-8. doi: 10.1097/00000441-200212000-00009.
To examine the prevalence and characteristics of arterial thromboembolism in patients with adenocarcinoma of the pancreas.
Retrospective review of charts of all patients with cancer of the pancreas diagnosed and followed at a regional teaching hospital over a decade.
In total, 320 patients were diagnosed and 311 were available for evaluation. Two patients with arterial thromboembolism were identified (0.65%) and studied. Both had extensive metastatic disease on diagnosis and, soon after, developed an acute arterial occlusion of the iliac and femoral arteries, with no identifiable embolic source (case 1) or acute intestinal infarction due to mesenteric and multiple other embolic arterial occlusions associated with nonbacterial thrombotic endocarditis (NBTE) of the mitral valve (case 2). Both cases had laboratory evidence of disseminated intravascular coagulation and succumbed to their illnesses within a very short time.
Arterial occlusion in pancreatic cancer is a rare preterminal event that may be caused by cardiogenic emboli from NBTE or to thrombosis in situ. The pathogenesis is briefly reviewed.
研究胰腺癌患者动脉血栓栓塞的发生率及特征。
回顾性分析一家地区教学医院在十年间诊断并随访的所有胰腺癌患者的病历。
总共诊断出320例患者，其中311例可供评估。确定了2例动脉血栓栓塞患者（0.65%）并进行研究。两例患者在诊断时均有广泛转移疾病，随后很快出现髂动脉和股动脉急性闭塞，其中1例未发现栓子来源（病例1），另1例因二尖瓣非细菌性血栓性心内膜炎（NBTE）导致肠系膜及多处其他动脉栓塞性闭塞而发生急性肠梗死（病例2）。两例患者均有弥散性血管内凝血的实验室证据，并在短时间内死亡。
胰腺癌中的动脉闭塞是一种罕见的终末期前事件，可能由NBTE的心源性栓子或原位血栓形成引起。本文简要回顾了其发病机制。
