2022 Volume 37 Issue 5 Pages 274-280
A 79-year-old woman presented with sudden onset of upper-abdominal pain and nausea. Contrast-enhanced computed tomography scan revealed splenic infarction and a thrombus in the descending aorta. Anticoagulation and antiplatelet therapy were begun. One day after admission, the abdominal pain acutely worsened, and the amylase level and white blood cell count were elevated. Computed tomography scan revealed occlusion of the gastroduodenal artery due to a thrombus and parenchyma in the pancreatic body was not enhanced, while the thrombus in the descending aorta disappeared. The patient was diagnosed with acute pancreatitis caused by pancreatic ischemia due to thromboembolism. Although necrotizing pancreatitis with acute necrotic collection and walled-off necrosis developed, the patient recovered with non-operative treatment including antibiotics. The thrombus in the gastroduodenal artery resolved without further intervention. The patient was discharged in good condition 25 days after admission.
The thromboembolism led to pancreatic ischemia and acute pancreatitis which is often followed by a more serious course than other causes with a high mortality rate. Ischemic pancreatitis resolved after treatment with antithrombotic therapy and treatment for acute pancreatitis. We report a patient with ischemic pancreatitis due to the occlusion of gastroduodenal artery.
