A Case of Ischemic Pancreatitis After Acute Aortic Dissection

一例急性主动脉夹层后缺血性胰腺炎

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Abstract

A 52-year-old man with hypertension presented with sudden-onset lower back pain and numbness in both lower limbs. Imaging revealed a Stanford type A aortic dissection extending from the ascending aorta to the left common iliac artery, with compression of the celiac artery and partial thrombosis of the superior and inferior mesenteric arteries. The patient underwent ascending aortic replacement surgery. On postoperative day 3, he developed intestinal ischemia, requiring a subtotal colectomy. By postoperative day 10, he developed fever and hypotension, and subsequent imaging revealed ischemic pancreatitis localized to the pancreatic body. This was attributed to celiac artery stenosis due to false lumen compression and superior mesenteric artery dissection. He gradually recovered with conservative management, including fluid therapy and percutaneous cyst drainage. This case highlights the importance of recognizing ischemic pancreatitis as a delayed complication of aortic dissection, particularly in cases involving impaired visceral blood flow.

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