Zacharia George S, Mandalapu Navya, Mokan Dasan Saran Lal A, Gadde Sindhu K, Bansal Shivani, Bansal Sudha
Internal Medicine, BronxCare Health System, Bronx, USA.
Medical Education, American University of the Caribbean School of Medicine, Cupecoy, SXM.
Cureus. 2025 Jul 23;17(7):e88624. doi: 10.7759/cureus.88624. eCollection 2025 Jul.
Acute pancreatitis, a common cause of acute abdomen, is known to have a broad spectrum of local and systemic complications. Vascular complications of acute pancreatitis are vastly underreported. Our case, a 66-year-old male patient with alcohol-induced acute pancreatitis and concurrent severe ethanol withdrawal syndrome, who developed extensive thrombotic events early in the disease course, is a rare and intriguing presentation. The patient had concurrent thrombosis involving the distal superior mesenteric vein, the greater saphenous vein, and pulmonary embolism. This case highlights a multifocal and early onset of venous thrombosis complicating acute pancreatitis, an atypical but clinically significant presentation. The role of anticoagulation in patients with isolated splanchnic venous thrombosis in acute pancreatitis remains unclear; however, our patient was managed with low-molecular-weight heparin, owing to the presence of pulmonary embolism and extremity vein thrombosis. Further studies are needed to guide optimal management strategies in such complex presentations.
急性胰腺炎是急腹症的常见病因，已知会出现广泛的局部和全身并发症。急性胰腺炎的血管并发症报告严重不足。我们的病例是一名66岁男性患者，患有酒精性急性胰腺炎并并发严重酒精戒断综合征，在病程早期出现广泛血栓形成事件，是一种罕见且引人关注的表现。该患者同时发生血栓形成，累及肠系膜上静脉远端、大隐静脉和肺栓塞。本病例突出了急性胰腺炎并发多灶性和早期静脉血栓形成，这是一种非典型但具有临床意义的表现。抗凝在急性胰腺炎孤立性内脏静脉血栓形成患者中的作用仍不明确；然而，由于存在肺栓塞和肢体静脉血栓形成，我们的患者接受了低分子量肝素治疗。需要进一步研究以指导此类复杂情况的最佳管理策略。
