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Vascular Complications in Patients with Chronic Pancreatitis

Title: Vascular Complications in Patients with Chronic Pancreatitis
Authors: Miroslav Vujasinovic; Ana Dugic; Amar Nouri; Torkel B Brismar; Francisco Baldaque-Silva; Ebba Asplund; Wiktor Rutkowski; Poya Ghorbani; Ernesto Sparrelid; Hannes Hagström; J.-Matthias Löhr
Source: Journal of Clinical Medicine, Vol 10, Iss 3720, p 3720 (2021)
Publisher Information: MDPI AG
Publication Year: 2021
Collection: Directory of Open Access Journals: DOAJ Articles
Subject Terms: chronic pancreatitis; splanchnic circulation; hepatic vein thrombosis; pseudoaneurysm; vascular complications; Medicine
Description: Introduction: Chronic pancreatitis (CP) is a long-standing progressive inflammation of the pancreas, which can lead to a variety of vascular complications, such as splanchnic venous thrombosis (VT) and arterial pseudoaneurysm (PA). There is a lack of studies on vascular complications in Scandinavian countries. Methods: We performed a retrospective analysis of medical records of patients with CP identified from the Karolinska University Hospital database between 2003 and 2018. A total of 394 patients with definite CP were included in the study. Results: There were 33 patients with vascular complications, with a median age of 62 (IQR 55–72) years. The cumulative incidence of vascular events was 3.2% at 5 years. Thirty patients had isolated VT, whereas three patients had PA (7.6% and 0.8%, respectively). Isolated splenic vein thrombosis was most common (53.3%), followed by a combination with other splanchnic veins. PA was found in the splenic artery in two patients and in the left gastric artery in one patient. Varices were present in three (10%) patients; variceal bleeding was not recorded. All patients had asymptomatic splanchnic VT, most with chronic VT with developed collaterals (83.3% had abdominal collateral vessels). Nearly two-thirds of patients with VT (63.3%) received no treatment, whereas 11 (36.6%) were treated with anticoagulants. Pseudocysts and alcoholic etiology of CP are risk factors for vascular complications. Conclusions: The cumulative incidence of vascular complications was 3.2% at 5 years. Splanchnic VT is more common than PA. Patients were asymptomatic with no variceal bleeding, explained by well-developed collateral vessels and strong study inclusion criteria.
Document Type: article in journal/newspaper
Language: English
Relation: https://www.mdpi.com/2077-0383/10/16/3720; https://doaj.org/toc/2077-0383; https://doaj.org/article/8c6a152a953145d284452c81456cccf1
DOI: 10.3390/jcm10163720
Availability: https://doi.org/10.3390/jcm10163720; https://doaj.org/article/8c6a152a953145d284452c81456cccf1
Accession Number: edsbas.82B7CB6B
Database: BASE