Acute Pancreatitis Following Pharmacomechanical Thrombectomy: A Rare Complication

A 35-year-old female presented to the emergency department (ED) with a three-day history of left lower limb edema and discomfort. A venous duplex scan and computed tomography (CT) venogram showed a left iliofemoral deep vein thrombosis (DVT). The CT also demonstrated compression of the left common iliac vein by the right common iliac artery, suggesting May-Thurner syndrome.   The iliofemoral DVT was treated with pharmacomechanical thrombectomy (PMT), which resulted in successful revascularization of the left common iliac and femoral veins.  The following day the patient developed severe epigastric pain with raised amylase levels, leading to a diagnosis of acute interstitial pancreatitis, which was thought to be secondary to massive hemolysis.   Despite the general tolerability of mechanical thrombectomy, complications such as hemorrhage, pseudoaneurysm, and dissection may occur.  Acute pancreatitis post-thrombectomy is rare, with very few cases reported in the literature, primarily documented in patients with renal insufficiency and co-morbidities. Awareness of acute pancreatitis as a rare complication post-procedure is crucial, especially when abdominal pain is unexplained.