Korean J Gastroenterol.  2023 Mar;81(3):137-141. 10.4166/kjg.2023.020.

Ischemic Acute Pancreatitis Associated with Abdominal Aortic Aneurysm

• Lee WH
• Son JH
• Lee YS

• KMID: 2540958
• DOI: http://doi.org/10.4166/kjg.2023.020

Figure

• 

  Fig. 1 Abdominal computed tomography before (A) and after (B) contrast injection shows diffuse swelling and loss of lobulated contour of the pancreas and peripancreatic infiltration.

• 

  Fig. 2 Abdominal computed tomography shows aneurysmal dilatation with mural thrombus in the abdominal aorta (maximal diameter of 7 cm) on horizontal (A) and coronal view (B).

• 

  Fig. 3 Abdominal computed tomography shows severe atherosclerotic changes on the root of the celiac trunk (A–C) and superior mesenteric artery (D–F).

• 

  Fig. 4 Abdominal computed tomography shows a normal gallbladder without radio-opaque biliary stones (A), and abdominal ultrasonography also shows a normal gallbladder (B).

• 

  Fig. 5 Magnetic resonance cholangiopancreatography shows no radiolucent gallbladder or bile duct stones on horizontal (A) and coronal view (B). There is no abnormality in the pancreatic duct (C) and pancreas parenchyma (D).

Reference

1. Banks PA, Bollen TL, Dervenis C, et al. Acute Pancreatitis Classification Working Group. Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013; 62:102–111. DOI: 10.1136/gutjnl-2012-302779. PMID: 23100216.

2. Peery AF, Crockett SD, Barritt AS, et al. 2015; Burden of gastrointestinal, liver, and pancreatic diseases in the United States. Gastroenterology. 149:1731–1741.e3. DOI: 10.1053/j.gastro.2015.08.045. PMID: 26327134. PMCID: PMC4663148.

3. Gapp J, Hall AG, Walters RW, Jahann D, Kassim T, Reddymasu S. 2019; Trends and outcomes of hospitalizations related to acute pancreatitis: epidemiology from 2001 to 2014 in the United States. Pancreas. 48:548–554. DOI: 10.1097/MPA.0000000000001275. PMID: 30946239.

4. Sadr-Azodi O, Oskarsson V, Discacciati A, Videhult P, Askling J, Ekbom A. 2018; Pancreatic cancer following acute pancreatitis: a population-based matched cohort study. Am J Gastroenterol. 113:1711–1719. DOI: 10.1038/s41395-018-0255-9. PMID: 30315287.

5. Munigala S, Kanwal F, Xian H, Scherrer JF, Agarwal B. 2014; Increased risk of pancreatic adenocarcinoma after acute pancreatitis. Clin Gastroenterol Hepatol. 12:1143–1150.e1. DOI: 10.1016/j.cgh.2013.12.033. PMID: 24440214.

6. Badalov N, Baradarian R, Iswara K, Li J, Steinberg W, Tenner S. 2007; Drug-induced acute pancreatitis: an evidence-based review. Clin Gastroenterol Hepatol. 5:648–661. quiz 644DOI: 10.1016/j.cgh.2006.11.023. PMID: 17395548.

7. Bertilsson S, Kalaitzakis E. 2015; Acute pancreatitis and use of pancreatitis-associated drugs: a 10-year population-based cohort study. Pancreas. 44:1096–1104. DOI: 10.1097/MPA.0000000000000406. PMID: 26335010.

8. Hackert T, Hartwig W, Fritz S, Schneider L, Strobel O, Werner J. 2009; Ischemic acute pancreatitis: clinical features of 11 patients and review of the literature. Am J Surg. 197:450–454. DOI: 10.1016/j.amjsurg.2008.04.011. PMID: 18778810.

9. Sakorafas GH, Tsiotos GG, Sarr MG. 2000; Ischemia/Reperfusion-Induced pancreatitis. Dig Surg. 17:3–14. DOI: 10.1159/000018793. PMID: 10720825.

10. Reilly PM, Toung TJ, Miyachi M, Schiller HJ, Bulkley GB. 1997; Hemodynamics of pancreatic ischemia in cardiogenic shock in pigs. Gastroenterology. 113:938–945. DOI: 10.1016/S0016-5085(97)70190-2. PMID: 9287987.

11. Ertan A, Schneider FE. 1995; Acute pancreatitis in long-distance runners. Am J Gastroenterol. 90:70–71.

12. Orvar K, Johlin FC. 1994; Atheromatous embolization resulting in acute pancreatitis after cardiac catheterization and angiographic studies. Arch Intern Med. 154:1755–1761. DOI: 10.1001/archinte.1994.00420150131013. PMID: 8042893.

13. Fernández-del Castillo C, Harringer W, Warshaw AL, et al. 1991; Risk factors for pancreatic cellular injury after cardiopulmonary bypass. N Engl J Med. 325:382–387. DOI: 10.1056/NEJM199108083250602. PMID: 1712076.

14. Warshaw AL, O'Hara PJ. 1978; Susceptibility of the pancreas to ischemic injury in shock. Ann Surg. 188:197–201. DOI: 10.1097/00000658-197808000-00012. PMID: 686887. PMCID: PMC1396740.

15. Hamamoto M. 2012; Acute ischemic pancreatitis associated with acute type B aortic dissection: a case report. Ann Vasc Dis. 5:385–388. DOI: 10.3400/avd.cr.12.00029. PMID: 23555541. PMCID: PMC3595860.

16. Umeda I, Hayashi T, Ishiwatari H, et al. 2011; [A case of severe acute pancreatitis and ischemic gastropathy caused by acute aortic dissection]. Nihon Shokakibyo Gakkai Zasshi. 108:103–110. Japanese.

17. Gullo L, Cavicchi L, Tomassetti P, Spagnolo C, Freyrie A, D'Addato M. 1996; Effects of ischemia on the human pancreas. Gastroenterology. 111:1033–1038. DOI: 10.1016/S0016-5085(96)70072-0. PMID: 8831599.

18. Okahara M, Mori H, Kiyosue H, Yamada Y, Sagara Y, Matsumoto S. 2010; Arterial supply to the pancreas; variations and cross-sectional anatomy. Abdom Imaging. 35:134–142. DOI: 10.1007/s00261-009-9581-0. PMID: 19777288.

19. Cocota I, Badea R, Scridon T, Dumitrascu DL. 2015; Ischemic acute pancreatitis with pancreatic pseudocyst in a patient with abdominal aortic aneurysm and generalized atheromatosis - case report. BMC Gastroenterol. 15:35. DOI: 10.1186/s12876-015-0258-6. PMID: 25887669. PMCID: PMC4374579.