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Crohn's disease (CD) is an idiopathic inflammatory bowel disease which can involve any part of the gastrointestinal tract. It frequently involves the ileum, colon and the anorectum. Although rare, acute pancreatitis as a complication of CD involving the duodenum has been described in the literature. We describe a 37-year-old male with CD presenting...
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Acute pancreatitis is an extraintestinal manifestation of inflammatory bowel disease. There have been few reports describing acute pancreatitis preceding a diagnosis of inflammatory bowel disease. We herein report a rare case of a 16-year-old boy with presymptomatic Crohn's disease that was newly diagnosed just after the onset of idiopathic acute p...
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... No active intervention is required if the patient is hemodynamically stable; these patients can be kept under close clinical and sonographic monitoring. Conservative approach was employed by Mujtaba et al., in a hemodynamically stable patient of acute pancreatitis (with crohn's disease) who developed SSR following SV thrombosis [12], Rypens et al., [11]suggested a wait and watch policy since pancreatitis associated splenic complications may potentially regress over time. On the contrary, surgical intervention is warranted if the patient has precipitous drop in blood pressure or develops signs of peritonitis [12]. ...
... Conservative approach was employed by Mujtaba et al., in a hemodynamically stable patient of acute pancreatitis (with crohn's disease) who developed SSR following SV thrombosis [12], Rypens et al., [11]suggested a wait and watch policy since pancreatitis associated splenic complications may potentially regress over time. On the contrary, surgical intervention is warranted if the patient has precipitous drop in blood pressure or develops signs of peritonitis [12]. ...
Objective: Rare co-existance of disease or pathology. Background: Portal vein thrombosis is an unusual clinical condition due to multiple etiological and morbidity factors. In some cases, Portal vein thrombosis remains undiagnosed and discovered incidentally during aregular check up for a known cause. Case Report: we report a rare case of portal vein thrombosis associated with acute pancreatitis of 58-year-old man. Conclusions: Although vascular complications such as Portal vein thrombosis after pancreatitis are exceptional. It should be expected in any patient with pancreatitis. These complications, if diagnosed and treated early, will significantly reduce morbidity and mortality.
... In current concepts, non-traumatic splenic ruptures are usually pathological ruptures associated with diseases. Many etiologies of non-traumatic splenic ruptures have been reported, such as infections, vasculitis, pancreatitis, or hematological malignancies [2][3][4]. Acute lymphoblastic leukemia (ALL) remains a rare cause of non-traumatic splenic rupture that physicians are required to assess for. Due to the unspecific symptoms, a spontaneous splenic rupture may mimic perforated viscus, Diagnostics 2019, 9, 152 2 of 7 acute pancreatitis, rupture of aortic aneurysm, or acute coronary syndrome, delaying the diagnosis. ...
A spontaneous rupture of the spleen is a rare but critical diagnosis of an acute abdomen, which may accompany unspecific symptoms mimicking acute pancreatitis, rupture of aortic aneurism, or acute coronary syndrome, delaying diagnosis and treatment. In patients that have experienced a severe spleen rupture, hypovolemic shock may cause catastrophic clinical outcomes. Therefore, early diagnosis is very important in order for physicians to declare the etiology for prevention and timely correction of the shock status. Several causes of spontaneous splenic rupture have been reported, including infection, vasculitis, pancreatitis, or hematological malignancies. Acute lymphoblastic leukemia (ALL) remains a rare but important cause of non-traumatic splenic rupture that physicians are required to assess for. Here, we describe a case presenting an acute abdomen due to spontaneous spleen rupture as the first manifestation. The purpose of this case report was to highlight the importance of considering spontaneous ruptures of the spleen as a rare but critical differential diagnosis of an acute abdomen, especially in patients with acute lymphoblastic leukemia.
... The leading etiology of pancreatitis complicated by splenic rupture was alcohol consumption (67.9%, 19/28). [13][14][15][16]18,19,21,23,[26][27][28][29][30][33][34][35][36] Of the remaining cases, 7.1% (2/28) were idiopathic; 36 3.6% (1/28) were related to Crohn' s disease; 17 and 21.4% (6/28) had no specified etiology. 20,22,24,25,31,32 ...
... [18][19][20]31,36 Further, 64.3% (18/28) of the cases had splenic rupture or subcapsular hematoma on presentation. [14][15][16][17][18][19][20]22,24,26,28,29,[32][33][34][35][36] The other patients developed rupture or hematoma during hospitalization mostly within 1 week (32.1%, 9/28), 13,21,23,25,27,30,36 while one patient developed hematoma after 1 month of presentation. ...
... 13 Splenic vein thrombosis was present in 21.4% (6/28) of the cases. 13,17,20,23,36 More than half of the cases (71.4%, 20/28) had either chronic pancreatitis or history of acute pancreatitis. In total, 92.8% (26/28) of the cases had one ...
Splenic hemorrhage (hematoma and rupture) is a rare complication of pancreatitis. In this article, we present a rare case of spontaneous splenic rupture as a complication of acute pancreatitis. A literature review was also completed to describe the patient characteristics, associated pancreatitis etiology, clinical presentations, risk factors, diagnostic and treatment modalities, and outcomes.
... SSR is an uncommon surgical emergency. Clinical features include left hypochondriac pain, hypotension, guarding and rigidity [30,31]. Kehr's sign may be positive [30]. ...
... High index of suspicion is necessary and any patient of acute pancreatitis presenting with signs of shock should be evaluated for SSR. Management depends on hemodynamic stability, degree of hemoperitoneum and severity of splenic injury [31]. ...
... No active intervention is required if the patient is hemodynamically stable; these patients can be kept under close clinical and sonographic monitoring. Conservative approach was employed by Mujtaba et al. in a hemodynamically stable patient of acute pancreatitis (with crohn's disease) who developed SSR following SV thrombosis [31]. Similarly, Rypens et al. [30]suggested a wait and watch policy since pancreatitis associated splenic complications may potentially regress over time. ...
Pancreatitis is notorious to cause vascular complications. While arterial complications include pseudoaneurysm formation with a propensity to bleed, venous complications can be quite myriad. Venous involvement in pancreatitis often presents with thrombosis. From time to time case reports and series of unusual venous complications associated with pancreatitis have, however, been described. In this article, we review multitudinous venous complications in the setting of pancreatitis and propose a system to classify pancreatitis associated venous complications.
... These complications are splenic vein thrombosis, arterial pseudoaneurysm, intrasplenic pancreatic pseudocyst and splenic rupture and are encountered in 1-5% of the cases (18). Cases of splenic rupture due to pancreatitis have been reported, though rarely (19,20). In addition, there have been cases of splenic vein rupture during pregnancy and the puerperium (21). ...
Acute pancreatitis can be encountered as a rare complication of thrombotic thrombocytopenic purpura and it has been associated with recurrent thrombotic thrombocytopenic purpura. In this report, we present a case of thrombotic thrombocytopenic purpura closely followed for recurrent acute pancreatitis attacks and having a lethal clinical picture due to splenic vein rupture in spite of plasmapheresis and steroid treatments.
... Literatürde, etyolojik nedenlerin sıklık sırasına göre; enfeksiyöz, inflamatuvar ve neoplazmlar olarak sıralandığı yayınlarda vardır (5,6). Literatürde en yeni ve geniş seri Elvy ve ark. ...
Atraumatic splenic rupture is an uncommon complication of acute pancreatitis. This article presents a case of a 35-year-old patient presenting with acute pancreatitis who subsequently developed a splenic vein thrombosis and splenic rupture requiring a laparotomy and splenectomy. This rare but life-threatening complication requires prompt recognition and management in patients with pancreatitis who develop sudden hemodynamic instability.
Spontaneous rupture of the spleen is a rare disorder and has been reported to occur due to Haematological, neoplastic and
infectious diseases involving the spleen. We present a case of 25 years young male who presented with epigastric pain and fever
since four days. The contrast-enhanced computed tomography scan showed complete distortion of splenic architecture with
perisplenic mixed density collection that suggested splenic rupture. Pancreas was bulky in the tail region with adjacent fluid density
collection. The peripancreatic fluid in the tail region eroded the splenic capsule and penetrated into splenic parenchyma causing
spontaneous rupture of the spleen. It also eroded the vessel and caused haematoma. Splenic artery embolisation was done and
later managed conservatively.
Atraumatic splenic rupture is an uncommon complication of acute pancreatitis. This report describes the case of a 30-year-old man with acute pancreatitis and splenic vein thrombosis complicated by splenic rupture. The patient was admitted to the emergency department with pain in the upper abdomen that had been present for six hours and was associated with vomiting and sweating. He was diagnosed with acute pancreatitis of alcoholic etiology. Upon computed tomography (CT) of the abdomen, the pancreatitis was scored as Balthazar C grade, and a suspicious area of necrosis affecting 30% of the pancreas with splenic vein thrombosis was revealed. Seventy-two hours after admission, the patient had significant improvement in symptoms. However, he showed clinical worsening on the sixth day of hospitalization, with increasing abdominal distension and reduced hemoglobin levels. A CT angiography showed a large amount of free fluid in the abdominal cavity, along with a large splenic hematoma and contrast extravasation along the spleen artery. The patient subsequently underwent laparotomy, which showed hemoperitoneum due to rupture of the splenic parenchyma. A splenectomy was then performed, followed by ultrasound-guided percutaneous drainage.
