Acute pancreatitis complicated by portal vein thrombus
Severe abdominal pain for three days. Persistent vomiting, tachycardia, hypotensive.
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Peripancreatic fluid and fat stranding tracking inferiorly to the pelvis. Pancreas is swollen. Filling defect in the distal superior mesenteric vein extending into the main and left portal veins. Splenic vein is completely thrombosed.
Hepatic steatosis. Bilateral simple appearing renal cysts.
Case DiscussionInitial lipase was 1493 IU/L (upper limit of normal 59 IU/L). Subsequent ultrasound did not demonstrate gallstones, and the presumed cause is alcohol.
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