Download PDF
CC BY-NC-ND 4.0 · Journal of Health and Allied Sciences NU 2018; 08(01): 45-47
DOI: 10.1055/s-0040-1708743
Original Article

Superior Mesenteric Artery Thrombosis; Rare complication after Pancreaticoduodenectemy

Satyaprakash Jindal
1   DNB trainee, Department of GI surgery, Indraprastha Apollo Hospital, Delhi
,
Adithya G. K.
1   DNB trainee, Department of GI surgery, Indraprastha Apollo Hospital, Delhi
,
Vachan Hukkeri
1   DNB trainee, Department of GI surgery, Indraprastha Apollo Hospital, Delhi
,
Varun Madaan
4   DNB trainee, Department of GI surgery, Indraprastha Apollo Hospital, Delhi
,
Chitra,
Sandeep Vohra
6   Senior consultant, Dept of radiology, Indraprastha Apollo Hospital, Delhi
,
Vivek Tandon
7   Senior consultant, Department of GI surgery, Indraprastha Apollo Hospital, Delhi
,
Deepak Govil
8   Senior consultant, Department of GI surgery, Indraprastha Apollo Hospital, Delhi
› Author Affiliations
› Further Information
Also available at
  PDF Download Permissions and Reprints

Abstract

Pancreaticoduodenectemy(PD) is the treatment of choice for malignant and some benign diseases of the pancreas and periampullary region. Common complications after PD include delayed gastric emptying, pancreatic fistula, anastomotic leak and intra abdominal collection. Postoperative medical complications include arrhythmia, renal failure, pulmonary complications, UTI and Deep vein thrombosis. Superior mesenteric artery (SMA) thrombosis is rarely been reported after PD. There is theoretical possibility of arterial thrombosis in patient with history of vascular disease, which may precipitate after postoperative hypovolemia. SMA thrombosis is difficult to diagnose in postoperative period due to nonspecific symptoms and associated with high mortality rate up to 80-90%. Our patient was a 68 years old female with lower end cholangiocarcinoma without any other co-morbidity. She underwent PD without any intraoperative complications. Post operatively she developed SMA thrombosis. Unfortunately patient could not be salvaged and she succumbs to death.

Keywords

SMA thrombosis - Pancreaticoduodenectemy - cholangiocarcinoma


Publication History

Received: 10 October 2017

Accepted: 28 January 2018

Article published online:
20 April 2020

© .

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • References

  • 1 Van Heek NT, Kuhlmann KF, Scholten RJ, de Castro SM, Busch OR, van Gulik TM, et al. Hospital volume and mortality after pancreatic resection: a systematic review and an evaluationof intervention in the Netherlands. Ann Surg. 2005; 242(6):781–8.
  • 2 Lin JW, Cameron JL, Yeo CJ, et al. Risk factors and outcomes in post pancreaticoduodenectomy pancreaticocutaneous fistula. J Gastrointest Surg 2004; 8(8):951–9.
  • 3 Saraee et al. Whipple procedure: a review of a 7-year clinical experience in a referral center for hepatobiliary and pancreas diseases World Journal of Surgical Oncology (2015) 13:98 DOI 10.1186/s12957-015-0523-8
  • 4 Schoots IG, Koffeman GI, Legemate DA, Levy M, Van Gulik TM: Systematic review of survival after acute mesenteric ischemia according to disease aetiology. Br J Surg 2004, 91:17-21.
  • 5 JarvinenO, Laurikka J, Salenius JP, Tarkka M.Acute intestinal ischaemia. A review of 214 cases. Ann Chir Gynaecol. 1994; 83(1):22-5.
  • 6 Charles J. Shanley, MD, FACS*, Jeffrey B. Weinberger, MD Acute Abdominal Vascular Emergencies Med Clin N Am 92 (2008) 627–647
  • 7 MenkeJ. Diagnostic accuracy of multidetector CT in acute mesenteric ischemia: systematic review and meta-analysis. Radiology. 2010; 256(1):93-101.
  • 8 Schoots IG, Levi MM, Reekers JA, et al. Thrombolytic therapy for acute superior mesentericartery occlusion. J VascIntervRadiol 2005; 16(3):317–29.
  • 9 Bjorck M, Acosta S, Lindberg F, Troeng T, Bergqvist D. Revascularization of the superior mesenteric artery after acute thromboembolic occlusion.