Spectrum and Frequency of Vascular Complications of Pancreatitis on Contrast-Enhanced CT Angiography
DOI:
https://doi.org/10.61336/jdme.0704.18Keywords:
Pancreatitis, CT. Angiography, Vascular ComplicationsAbstract
Vascular complications of pancreatitis include splanchnic venous thrombosis, arterial pseudoaneurysms, and haemorrhage. Contrast-enhanced CT angiography permits assessment of these abnormalities alongside pancreatic inflammation, necrosis, and collections. Aim: To evaluate the spectrum and frequency of vascular complications of pancreatitis on contrast-enhanced CT angiography. Materials and Methods: This illustrative analysis included 61 patients comprising 45 with acute pancreatitis and 16 with chronic pancreatitis. Vascular abnormalities were categorized by type, anatomical distribution, and CT angiographic features. Frequencies were expressed as n (%) with Wilson 95% confidence intervals. Associations with pancreatitis type, necrosis, collections, and CT severity were assessed using exact tests. Unadjusted odds ratios with 95% confidence intervals were calculated for binary comparisons. Results: Vascular complications were represented in 18 patients (29.5%; 95% CI: 19.6-41.9%). Venous complications alone occurred in 12 (19.7%), arterial complications alone in three (4.9%), and combined involvement in three (4.9%). Splanchnic venous thrombosis affected 15 patients (24.6%), most frequently involving the splenic vein (18.0% of the total sample). Pseudoaneurysms occurred in five patients (8.2%) and active arterial extravasation in two (3.3%). Within acute pancreatitis, vascular complications were associated with necrosis (OR: 8.00; 95% CI: 1.76-36.38; p = 0.006) and collections (OR: 6.00; 95% CI: 1.13-31.74; p = 0.040). Frequencies increased across mild, moderate, and severe CT categories (6.7%, 16.7%, and 66.7%; p = 0.002). The association with pancreatitis type was not significant (p = 0.526). Conclusion: The illustrative analysis demonstrated predominantly venous complications, with greater vascular involvement in acute pancreatitis accompanied by necrosis, collections, and higher CT severity. These associations require confirmation using actual patient data and appropriately adjusted analyses.
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