Vascular Complications in Patients with Chronic Pancreatitis

Introduction: Chronic pancreatitis (CP) is a long-standing progressive inflammation of the pancreas, which can lead to a variety of vascular complications, such as splanchnic venous thrombosis (VT) and arterial pseudoaneurysm (PA). There is a lack of studies on vascular complications in Scandinavian...

Full description

Bibliographic Details
Main Authors: Miroslav Vujasinovic, Ana Dugic, Amar Nouri, Torkel B Brismar, Francisco Baldaque-Silva, Ebba Asplund, Wiktor Rutkowski, Poya Ghorbani, Ernesto Sparrelid, Hannes Hagström, J.-Matthias Löhr
Format: Article
Language:English
Published: MDPI AG 2021-08-01
Series:Journal of Clinical Medicine
Subjects:
Online Access:https://www.mdpi.com/2077-0383/10/16/3720
id doaj-8c6a152a953145d284452c81456cccf1
record_format Article
spelling doaj-8c6a152a953145d284452c81456cccf12021-08-26T13:56:00ZengMDPI AGJournal of Clinical Medicine2077-03832021-08-01103720372010.3390/jcm10163720Vascular Complications in Patients with Chronic PancreatitisMiroslav Vujasinovic0Ana Dugic1Amar Nouri2Torkel B Brismar3Francisco Baldaque-Silva4Ebba Asplund5Wiktor Rutkowski6Poya Ghorbani7Ernesto Sparrelid8Hannes Hagström9J.-Matthias Löhr10Department of Upper Abdominal Diseases, Karolinska University Hospital, 141 86 Stockholm, SwedenDepartment of Medicine, Huddinge, Karolinska Institutet,141 86 Stockholm, SwedenDepartment of Medicine, Huddinge, Karolinska Institutet,141 86 Stockholm, SwedenDepartment of Radiology, Karolinska University Hospital, 141 86 Stockholm, SwedenDepartment of Upper Abdominal Diseases, Karolinska University Hospital, 141 86 Stockholm, SwedenDepartment of Medicine, Huddinge, Karolinska Institutet,141 86 Stockholm, SwedenDepartment of Upper Abdominal Diseases, Karolinska University Hospital, 141 86 Stockholm, SwedenDepartment of Upper Abdominal Diseases, Karolinska University Hospital, 141 86 Stockholm, SwedenDepartment of Upper Abdominal Diseases, Karolinska University Hospital, 141 86 Stockholm, SwedenDepartment of Upper Abdominal Diseases, Karolinska University Hospital, 141 86 Stockholm, SwedenDepartment of Upper Abdominal Diseases, Karolinska University Hospital, 141 86 Stockholm, SwedenIntroduction: Chronic pancreatitis (CP) is a long-standing progressive inflammation of the pancreas, which can lead to a variety of vascular complications, such as splanchnic venous thrombosis (VT) and arterial pseudoaneurysm (PA). There is a lack of studies on vascular complications in Scandinavian countries. Methods: We performed a retrospective analysis of medical records of patients with CP identified from the Karolinska University Hospital database between 2003 and 2018. A total of 394 patients with definite CP were included in the study. Results: There were 33 patients with vascular complications, with a median age of 62 (IQR 55–72) years. The cumulative incidence of vascular events was 3.2% at 5 years. Thirty patients had isolated VT, whereas three patients had PA (7.6% and 0.8%, respectively). Isolated splenic vein thrombosis was most common (53.3%), followed by a combination with other splanchnic veins. PA was found in the splenic artery in two patients and in the left gastric artery in one patient. Varices were present in three (10%) patients; variceal bleeding was not recorded. All patients had asymptomatic splanchnic VT, most with chronic VT with developed collaterals (83.3% had abdominal collateral vessels). Nearly two-thirds of patients with VT (63.3%) received no treatment, whereas 11 (36.6%) were treated with anticoagulants. Pseudocysts and alcoholic etiology of CP are risk factors for vascular complications. Conclusions: The cumulative incidence of vascular complications was 3.2% at 5 years. Splanchnic VT is more common than PA. Patients were asymptomatic with no variceal bleeding, explained by well-developed collateral vessels and strong study inclusion criteria.https://www.mdpi.com/2077-0383/10/16/3720chronic pancreatitissplanchnic circulationhepatic vein thrombosispseudoaneurysmvascular complications
collection DOAJ
language English
format Article
sources DOAJ
author Miroslav Vujasinovic
Ana Dugic
Amar Nouri
Torkel B Brismar
Francisco Baldaque-Silva
Ebba Asplund
Wiktor Rutkowski
Poya Ghorbani
Ernesto Sparrelid
Hannes Hagström
J.-Matthias Löhr
spellingShingle Miroslav Vujasinovic
Ana Dugic
Amar Nouri
Torkel B Brismar
Francisco Baldaque-Silva
Ebba Asplund
Wiktor Rutkowski
Poya Ghorbani
Ernesto Sparrelid
Hannes Hagström
J.-Matthias Löhr
Vascular Complications in Patients with Chronic Pancreatitis
Journal of Clinical Medicine
chronic pancreatitis
splanchnic circulation
hepatic vein thrombosis
pseudoaneurysm
vascular complications
author_facet Miroslav Vujasinovic
Ana Dugic
Amar Nouri
Torkel B Brismar
Francisco Baldaque-Silva
Ebba Asplund
Wiktor Rutkowski
Poya Ghorbani
Ernesto Sparrelid
Hannes Hagström
J.-Matthias Löhr
author_sort Miroslav Vujasinovic
title Vascular Complications in Patients with Chronic Pancreatitis
title_short Vascular Complications in Patients with Chronic Pancreatitis
title_full Vascular Complications in Patients with Chronic Pancreatitis
title_fullStr Vascular Complications in Patients with Chronic Pancreatitis
title_full_unstemmed Vascular Complications in Patients with Chronic Pancreatitis
title_sort vascular complications in patients with chronic pancreatitis
publisher MDPI AG
series Journal of Clinical Medicine
issn 2077-0383
publishDate 2021-08-01
description Introduction: Chronic pancreatitis (CP) is a long-standing progressive inflammation of the pancreas, which can lead to a variety of vascular complications, such as splanchnic venous thrombosis (VT) and arterial pseudoaneurysm (PA). There is a lack of studies on vascular complications in Scandinavian countries. Methods: We performed a retrospective analysis of medical records of patients with CP identified from the Karolinska University Hospital database between 2003 and 2018. A total of 394 patients with definite CP were included in the study. Results: There were 33 patients with vascular complications, with a median age of 62 (IQR 55–72) years. The cumulative incidence of vascular events was 3.2% at 5 years. Thirty patients had isolated VT, whereas three patients had PA (7.6% and 0.8%, respectively). Isolated splenic vein thrombosis was most common (53.3%), followed by a combination with other splanchnic veins. PA was found in the splenic artery in two patients and in the left gastric artery in one patient. Varices were present in three (10%) patients; variceal bleeding was not recorded. All patients had asymptomatic splanchnic VT, most with chronic VT with developed collaterals (83.3% had abdominal collateral vessels). Nearly two-thirds of patients with VT (63.3%) received no treatment, whereas 11 (36.6%) were treated with anticoagulants. Pseudocysts and alcoholic etiology of CP are risk factors for vascular complications. Conclusions: The cumulative incidence of vascular complications was 3.2% at 5 years. Splanchnic VT is more common than PA. Patients were asymptomatic with no variceal bleeding, explained by well-developed collateral vessels and strong study inclusion criteria.
topic chronic pancreatitis
splanchnic circulation
hepatic vein thrombosis
pseudoaneurysm
vascular complications
url https://www.mdpi.com/2077-0383/10/16/3720
work_keys_str_mv AT miroslavvujasinovic vascularcomplicationsinpatientswithchronicpancreatitis
AT anadugic vascularcomplicationsinpatientswithchronicpancreatitis
AT amarnouri vascularcomplicationsinpatientswithchronicpancreatitis
AT torkelbbrismar vascularcomplicationsinpatientswithchronicpancreatitis
AT franciscobaldaquesilva vascularcomplicationsinpatientswithchronicpancreatitis
AT ebbaasplund vascularcomplicationsinpatientswithchronicpancreatitis
AT wiktorrutkowski vascularcomplicationsinpatientswithchronicpancreatitis
AT poyaghorbani vascularcomplicationsinpatientswithchronicpancreatitis
AT ernestosparrelid vascularcomplicationsinpatientswithchronicpancreatitis
AT hanneshagstrom vascularcomplicationsinpatientswithchronicpancreatitis
AT jmatthiaslohr vascularcomplicationsinpatientswithchronicpancreatitis
_version_ 1714336929849278464