Learning objectives
This exhibit aims to provide a pictorial exhibit outlining the radiological features of acute pancreatitis as well as some of the associated vascular complications.
We will also provide examples of the role of interventional radiology in this field.
Background
Pancreatitis refers to an inflammatory process of the pancreas.
There exists a spectrum of presentations of pancreatitis,
with each patient running a variable clinical course.
Pancreatitis can carry with it significant morbidity,
including a range vascular complications which can be life threatening.
Internationally,
the incidence of acute pancreatitis is increasing (1,2).Data suggest the range in incidence of acute pancreatitis across Europe is 4.6 – 100/100,000 population (3).The approach to the diagnosis and management of pancreatitis is multi-disciplinary,
with diagnostic and interventional radiology fundamental to both....
Findings and procedure details
We outline below a number of vascular complications arising from pancreatitis.
Case 1: A 47 year oldpatient with acute pancreatitis,
secondary to alcohol,
who subsequently developed a large pseudoaneurysm of the gastroduodenal artery,
visualised on CT arterial phase imaging as well as on selective catheter angiography of the coeliac artery.
The patient subsequently went on to have percutaneous thrombin injection.
Case 2: An 82 year old patient with acute pancreatitis.
CT imaging demonstrates diffuse pancreatic & peri-pancreatic inflammation,
with occlusion of the splenic vein,
secondary...
Conclusion
The approach to the diagnosis and management of pancreatitis is multidisciplinary.
The vascular complications of pancreatitis can carry significant morbidity.
We suggest that those working in radiology follow a systematic approach in the assessment for such potential complications.
There should be close liaison between radiologists and the primary clinicians regarding the optimal investigation and management of all such patients.
References
(1)O'Farrell A,
Allwright S,
Toomey D,
et al.
Hospital admission for acute pancreatitis in the Irish population,
1997 2004: could the increase be due to an increase in alcohol-related pancreatitis? J Public Health (Oxf).
2007;29(4):398-404.
(2)Yadav D,
Lowenfels AB.
The Epidemiology of Pancreatitis and Pancreatic Cancer.
Gastroenterology.
2013;144(6):1252-61.
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(4)Mortele K,
Mergo P,
Taylor H,
et al.
Peripancreatic vascular abnormalities complicating acute pancreatitis: contrast-enhanced helical CT findings.
Eur J Radiol.
2004;52(1):67-72
(5)Kirby J,
Vora P,
Midia M,
et...