A Case of Ischemic Pancreatitis After Acute Aortic Dissection

Area of Science:

• Vascular Surgery
• Gastroenterology
• Cardiology

Background:

• Stanford type A aortic dissection is a life-threatening condition requiring prompt surgical intervention.
• Visceral artery compromise is a known complication of aortic dissection, potentially leading to organ ischemia.
• Delayed complications of aortic dissection, particularly involving the pancreas, are less commonly reported.

Observation:

• A 52-year-old male with hypertension presented with back pain and lower limb numbness, diagnosed with Stanford type A aortic dissection.
• The dissection involved visceral arteries, causing intestinal ischemia postoperatively, necessitating a subtotal colectomy.
• Delayed ischemic pancreatitis of the pancreatic body developed due to celiac artery stenosis and superior mesenteric artery dissection.

Findings:

• Ascending aortic replacement surgery was performed for the aortic dissection.
• Postoperative complications included intestinal ischemia and subsequent ischemic pancreatitis.
• Conservative management, including fluid therapy and cyst drainage, led to gradual recovery.

Implications:

• This case underscores the importance of considering ischemic pancreatitis as a delayed complication of aortic dissection.
• Vigilance for visceral complications is essential in patients with aortic dissection, especially with compromised visceral blood flow.
• Timely diagnosis and management of ischemic pancreatitis can improve patient outcomes in the context of aortic dissection.