Role of Multi Detector Computed Tomography in Evaluation of Vascular Complications of Pancreatitis: A Cross-sectional Study

Abstract

Introduction: The involvement of the blood vessels around the pancreas in pancreatitis may result in devastating complications. The proteolytic enzymes secreted by the inflamed pancreas can directly erode the walls of arteries in and around the pancreas, resulting in haemorrhage or pseudoaneurysms formation. On the other hand, the inflamed tissue may compress or thrombose adjoining veins. Multidetector Computed Tomography (MDCT) serves as an excellent tool for diagnosis and evaluation of complications of pancreatitis and can detect most vascular complications. Aim: To evaluate the MDCT findings of vascular complications associated with pancreatitis. Materials and Methods: This cross-sectional study was conducted on 60 patients at the Department of Radiology in the Tertiary Care Hospital attached to Mysore Medical College and Research Institute, Mysore, India for 12 months from 1st August 2019 to 31st July 2020. Each patient was subjected to unenhanced and contrast-enhanced CT to characterise the vascular complications associated with pancreatitis. The results were tabulated and evaluated descriptively by Microsoft excel 2016 and presented in figures and tables. Results: Of the 60 patients included, Splenic Vein Thrombosis (SVT) was seen in 39 (65%), followed by Portal Vein (PV) thrombosis in 17 (28.3%), Superior Mesenteric Vein (SMV) thrombosis in 14 (23.3%), all the three vein thrombosis was seen in 7 (11.6%) and arterial pseudoaneurysms was seen in 3 (5%). Conclusion: Vascular complications in pancreatitis are not uncommon but should be evaluated in all cases of pancreatitis. Contrast-enhanced CT is the main imaging modality for originally identifying local complications. SVT is one of the most frequently found vascular complications seen in patients of pancreatitis.

Keywords

• complications
• computed tomography scan
• pseudoaneurysms
• venous thrombosis