IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Pancreatic allograft thrombosis

Case contributed by Maradona Marcos Gabriel
Diagnosis certain

Presentation

A 40-year-old man with type I diabetes. Presents with abdominal pain and hyperglycemia 8 days after simultaneous transplantation of kidney and pancreas.

Patient Data

Age: 40 years
Gender: Male
ultrasound

IMAGE A: 

  •   US-image demonstrating VP and VE expanded, filled with echoes.
  •    Pancreas is heterogeneous, hypoechoic. Peripancreatic fluid collection.

IMAGE B:

  •  US-Duplex image within the pancreas parenchyma shows reversed end-diastolic flow in an intrapancreatic artery.
  • Venous waveforms could not be identified.

Central occlusive thrombosis of the PV. Normal pancreatic transplant enhancement. Post-contrast axial CT. Peripancreatic fluid collection.

Diagram

Illustration of the pancreas transplantation techniqueVCI: Inferior Vena Cava. VICD:  Right Common Iliac Vein. AO: Aorta. VP:  Portal Vein. VMS:  Superior Mesenteric Vein.  VE: Splenic Vein.  AICD:  Right Common Iliac Artery. IY: graft in ¨y¨ AMS: Superior Mesenteric Artery. AE: Splenic Artery.

Autore: G. Maradona

Case Discussion

Simultaneous transplantation of kidney and pancreas is a surgical option most used in patients with diabetic nephropathy. Complications can be classified into medical/surgical. 

Venous thrombosis is the most serious surgical complication and it is a cause of pancreatic loss. It is the second most important complication after rejection. and has a frequency of between 2-19% and typically presents a few weeks after transplant. 

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.