Re: Case 797_02 -- Pancreatitis with portal vein thrombosis after biopsy


Posted by Michael Soulen on July 21, 1997 at 13:40:39:

In Reply to: Case 797_02 -- Pancreatitis with portal vein thrombosis after biopsy posted by Editor on July 17, 1997 at 17:11:39:

The problem is excellently reviewed in Andy Adam's article on complications of biopsy in Seminars in Interventional Radiology, Vol 11, Sept. 1994, pp254-255. He notes pancreatitis following up to 3% of biopsies, sometimes fatal. Bowel was traversed in 21% f allcases, but 60% of those that developed pancreatitis, suggesting a relative contraindication to trans-colonic biopsy of the pancreas.

It is difficult to appreciate the extent of the portal thrombosis from the single image supplied, but if the patient were asymptomatic I don't see why it should be treated at all. The likelihood of a complication for anticoagulation in a patient with pancreatitis is likely greater than the hypothesized benefit. The PV thrombus most likely will resolve on its own.



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