Tsomidis I, Leonidou K, Papachristodoulou A, Rafailidis V, Prassopoulos P
Department of Gastroenterology and Hepatology, AHEPA Hospital, Thessaloniki, Greece.
Department of Nephrology, AHEPA Hospital, Thessaloniki, Greece.
Hippokratia. 2021 Jul-Sep;25(3):138-140.
BACKGROUND/AIM: Acute pancreatitis is a common gastrointestinal condition worldwide with variable severity and complications. Alcohol and gallstones are the leading causes of acute pancreatitis, while pancreatic ischemia is uncommon. Although venous thrombosis, especially adjacent to the inflamed pancreas, is a common complication of acute pancreatitis, arterial thrombosis secondary to pancreatitis has rarely been described. On the other hand, arterial thromboembolic events, secondary to cardiovascular diseases, are a rare cause of pancreatic ischemia. Herein, we present an interesting case of acute ischemic pancreatitis secondary to aortic atheromatosis complicated with multi-organ infarcts.
An 80-year-old male patient presented with nausea, abdominal pain, and vomiting accompanied by peripheral edema and ascites. Clinical, laboratory, and imaging investigation showed acute moderate to severe pancreatitis with multiple splenic and renal infarcts. An intraluminal free-floating aortic thrombus, secondary to atheromatosis of the descending aorta, was the cause of the complications. A conservative approach was successfully implemented, including supportive measures, antiplatelets, and vasodilators.
Identification of acute pancreatitis' cause, especially in the setting of a systemic disease like atheromatosis, is a challenging task and of great importance, given the implications on treatment decision-making and prevention of recurrent episodes. HIPPOKRATIA 2021, 25 (3):138-140.
背景/目的：急性胰腺炎是一种全球范围内常见的胃肠道疾病，严重程度和并发症各不相同。酒精和胆结石是急性胰腺炎的主要病因，而胰腺缺血并不常见。虽然静脉血栓形成，尤其是在炎症胰腺附近，是急性胰腺炎的常见并发症，但胰腺炎继发的动脉血栓形成很少被描述。另一方面，心血管疾病继发的动脉血栓栓塞事件是胰腺缺血的罕见原因。在此，我们报告一例有趣的病例，主动脉粥样硬化继发急性缺血性胰腺炎并伴有多器官梗死。
一名80岁男性患者出现恶心、腹痛和呕吐，并伴有外周水肿和腹水。临床、实验室和影像学检查显示急性中度至重度胰腺炎，伴有多个脾脏和肾脏梗死。降主动脉粥样硬化继发的腔内游离漂浮主动脉血栓是并发症的原因。成功实施了保守治疗方法，包括支持措施、抗血小板药物和血管扩张剂。
鉴于对治疗决策和预防复发的影响，确定急性胰腺炎的病因，尤其是在动脉粥样硬化等全身性疾病背景下，是一项具有挑战性且非常重要的任务。《希波克拉底》2021年，第25卷（第3期）：138 - 140页 。
