Title:Acute Pancreatitis Complicated by Thrombosis in the Right Brachiocephalic
Veins and Superior Vena Cava: A Case Report
Volume: 20
Author(s): Yan-li Zhang*, Bin Yang*, Fei Yu, Yong Liu, Guang-yan Si and Qi-zhou He
Affiliation:
- Department of Radiology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
- Department of Radiology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
Keywords:
Acute pancreatitis, Hyperlipidemia, Extra-splanchnic venous thrombosis, Computed tomography, Peripancreatic necrosis, Enzyme suppression.
Abstract:
Background:
Acute pancreatitis (AP) is one of the most common digestive emergencies, and vascular complication is one of the primary reasons for death, with
splanchnic venous thrombosis being the most common. Although extra-splanchnic venous thrombosis is rare, it carries the risk of life-threatening
secondary pulmonary embolism.
Case Presentation:
We have, herein, reported a case of AP complicated by rare brachiocephalic vein thrombosis and superior vena cava thrombosis. A 40 years old
woman was diagnosed with severe AP for abdominal pain 21 days ago. The patient received symptomatic treatment, including acid suppression,
enzyme suppression, lipid-lowering, fluid infusion, anti-infection, and continuous renal replacement therapy. The patient was discharged after
symptomatic relief. Recently, the patient was admitted again for middle-upper abdominal pain and discomfort. On admission, her blood platelet, DDimer,
fibrin degradation products (FDP), and triglyceride levels have been found to be increased; abdominal enhanced CT showed pancreatic
necrosis and an accumulation of peripancreatic necrosis and fluid, while chest enhanced CT suggested thrombosis in the right brachiocephalic vein
and superior vena cava. The patient, however, improved and was discharged after anticoagulation combined with insulin and trypsin inhibitors.
Conclusion:
In diagnosing and treating AP, dynamic monitoring of D-dimer levels is necessary for the timely detection of the development of thrombotic
complications.
