Endoscopy 2020; 52(S 01): S176
DOI: 10.1055/s-0040-1704545
ESGE Days 2020 ePoster Podium presentations
Friday, April 24, 2020 11:30 – 12:00 Vascular therapy ePoster Podium 3
© Georg Thieme Verlag KG Stuttgart · New York

VASCULAR COMPLICATIONS OF CHRONIC PANCREATITIS AND ROLE OF EUS IN MANAGEMENT: EXPERIENCE FROM TERTIARY CARE CENTER IN NORTHWESTERN INDIA

V Goel
1   Rajiv Gandhi Superspeciality Hospital, Delhi, India
2   Gastroenterology, SMS Hospital and Medical College, Jaipur, India
,
A Jhajharia
2   Gastroenterology, SMS Hospital and Medical College, Jaipur, India
,
V Chauhan
3   Gastroenterology, SMS Medical College and Hospital, Jaipur, India
,
M Ameta
2   Gastroenterology, SMS Hospital and Medical College, Jaipur, India
,
V Agarwal
3   Gastroenterology, SMS Medical College and Hospital, Jaipur, India
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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Aims To study the various vascular complications associated with chronic pancreatitis and role of EUS in their management.

Methods This is a prospective cohort study conducted at Department of Gastroenterology, SMS Hospital in Jaipur, Rajasthan for a period of three years from August 2015 till August 2018. The diagnosis of chronic pancreatitis was made on the basis of clinical, biochemical, and radiologic investigations. Additional investigations such as MRCP and EUS were performed when indicated.

Results A total of 402 subjects diagnosed as chronic pancreatitis were studied. The overall incidence of vascular complications in the study population was 19.4%(78/402).

Vascular complications indirectly related to chronic pancreatitis included splenic vein thrombosis in 7%(28/402), portal vein thrombosis in 4.5%(18/402) and duodenal ulcer in 1.2%(5/402) patients. Sinistral portal hypertension was present in 4%(16/402) patients. Vascular complications directly related to pancreatitis included pseudoaneurysm formation in 6.7%(27/402) patients. Splenic artery was the most common site seen in 37%(12/27) followed by gastroduodenal artery in 26%(7/27) patients.

Management 40.7%(11/27) pseudoaneurysms were asymptomatic and managed conservatively by observing for any change in size or any evidence of rupture documented by fall in hemoglobin levels. 59.3%(16/27) pseudoaneurysms bled. 8 patients were managed by EUS guided thrombin injection. 4 patients underwent endoluminal coil embolization of splenic artery pseudoaneurysm. 4 patients underwent ultrasound guided percutaneous glue embolization of splenic artery pseudoaneurysm. 35.7%(10/28) patients with splenic vein thrombosis presented with bleeding gastric varices, which were managed by EUS guided-glue injection in 8 and EUS guided-thrombin injection in 2 patients. A total of 21 patients were subjected to endoscopic interventions. Successful hemostasis was achieved in all patients with no immediate post procedure complications.

Conclusions The current study describes the various vascular complications of chronic pancreatitis and emerging role of EUS in their management.