Vascular Complications of Pancreatitis with Endovascular Treatment of Complications
Vascular Complications of Pancreatitis
Introduction: Most cases of pancreatitis are mild and self-limited. On the other hand, approximately one quarter of patients with pancreatitis may develop vascular complications. Vascular complications in pancreatitis are well recognized. Their exact incidence is not known. The most common complications are haemorrhage into a pseudocyst, erosions of the upper gastrointestinal arteries, thromboses of the portal venous system, formation of varices or pseudoaneurysms and rupture of a pseudoaneurysm. Pancreatitis in combination with vascular complications is dangerous and potentially lethal. The survival of patients with pancreatitis and vascular complications depends on the early diagnosis of these complications. This article focuses on the aetiology, presentation, recent developments in diagnosis and management of such complications. Material and Methods: Study done in the Department of Radiology from March 2019 to February 2020 at Meenakshi Medical college hospital and research institute, Kanchipuram, Tamilnadu to set the findings of the present study in the context of available evidence, a computerised literature search of PubMed, Embase, ISIS and CAS were carried out. The key words/subject headings used were “hemorrhage,” “pancreatitis,” “false aneurysms,” “venous thrombosis,” “angiography” and “therapeutic embolisation”. Limits applied were to restrict searches as follows: human and English language. All references were reviewed to retrieve additional articles. Other sources included review articles and text-books.
Result: Among the 169 attacks of acute pancreatitis, follow-up CT examinations depicted local complications in nine patients, for an overall incidence of 5.3%. There was a total of 16 complications, with three patients showing multiple complications. The number and percentage of patients with complications, number of complications, and number and percentage of follow-up examinations were calculated and correlated with the CT grading scale. Discussion: The development of abdominal complications in patients with acute pancreatitis leads to a prolonged hospitalization and, when life-threatening and not detected in time, to an increased mortality rate. Some of these complications may coexist, occur at any time after an acute attack, and have different manifestations and clinical repercussions. By and large, they are closely related to the staging severity of an acute attack of pancreatitis. Conclusion: Although the vascular complications following pancreatitis are not very common, they should be considered in every patient with pancreatitis. These complications if diagnosed and managed early was result in considerable reduction of morbidity and mortality.
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