Acute Pancreatitis-Associated Thrombotic Venopathy

Acute pancreatitis, a common cause of acute abdomen, is known to have a broad spectrum of local and systemic complications. Vascular complications of acute pancreatitis are vastly underreported. Our case, a 66-year-old male patient with alcohol-induced acute pancreatitis and concurrent severe ethanol withdrawal syndrome, who developed extensive thrombotic events early in the disease course, is a rare and intriguing presentation. The patient had concurrent thrombosis involving the distal superior mesenteric vein, the greater saphenous vein, and pulmonary embolism. This case highlights a multifocal and early onset of venous thrombosis complicating acute pancreatitis, an atypical but clinically significant presentation. The role of anticoagulation in patients with isolated splanchnic venous thrombosis in acute pancreatitis remains unclear; however, our patient was managed with low-molecular-weight heparin, owing to the presence of pulmonary embolism and extremity vein thrombosis. Further studies are needed to guide optimal management strategies in such complex presentations.