Arterial thrombosis can occur in necrotizing and interstitial pancreatitis and may present either early or later in the disease course, so awareness and timely imaging may facilitate prompt recognition and management.
A 61-year-old man with acute interstitial edematous pancreatitis superimposed on chronic pancreatitis developed extensive large-artery thrombosis detected four weeks after initial presentation.
Systemic anticoagulation led to radiologic resolution of the arterial thrombosis in the reported case.
A literature review identified 11 previously reported cases of acute pancreatitis-associated arterial thrombosis, giving 12 cases including the present one.
Arterial thrombosis occurred in both interstitial edematous and necrotizing pancreatitis among the 12 cases.
The aorta and major visceral arteries were the most frequently involved vessels in the reviewed cases.
Timing of arterial thrombosis detection varied, with most cases found within the first week but some diagnosed later.
This report describes a 61-year-old man with acute pancreatitis (on top of long-standing chronic pancreatitis) who kept having indigestion. A CT scan four weeks after his initial presentation showed fluid collections around the pancreas and, unexpectedly, extensive blood clots in several large arteries, including the aorta and arteries in the chest, abdomen, pelvis, and shoulder area. Treatment with blood thinners (anticoagulation) cleared the clots on follow-up imaging. The authors also reviewed earlier published cases and found 11 others, making 12 in total. Clots occurred in both mild (interstitial edematous) and severe (necrotizing) pancreatitis—5 and 7 cases respectively. The aorta and major arteries supplying the abdominal organs were most often affected. Seven cases were found in the first week, but five were found later, one as late as 60 days. This research suggests that arterial clots, although rare, can occur in pancreatitis of different severity and at different times, including weeks after onset. It suggests clinicians may want to be aware of this complication and consider imaging when symptoms persist. As this is a single case plus a small literature review, it cannot show how common the problem is or which treatments work best.
Cho M, Cho E, Oh H, Park C. (2026). Extensive Arterial Thrombosis Complicating Acute Pancreatitis: A Case Report and Literature Review.. The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi. https://doi.org/10.4166/kjg.2026.035