title: Ischemic acute pancreatitis with pancreatic pseudocyst in a patient with abdominal aortic aneurysm and generalized atheromatosis - case report.
abstract: BACKGROUND
  Ischemic pancreatitis is a rare medical entity. The pancreatic tissue is susceptible to ischemia with the possibility of developing acute pancreatitis. The abdominal aortic aneurysm can be one possible cause of pancreatic hypoperfusion.
  
  
  METHODS
  We report the case of a 68-year-old man, Caucasian, with a history of a cluster of severe cardiovascular conditions, who presented epigastric pain of variable intensity for about 2 weeks. The pain occurred after intense physical effort, and was associated with anorexia and asthenia. The palpation revealed epigastric pain and palpable pulsatile mass above the umbilicus. Laboratory tests showed increased serum and urine amylases. The abdominal contrast-enhanced CT scan evidenced acute lesions of the pancreas and a caudal pancreatic pseudocyst of 39x24 mm. An abdominal aortic aneurysm was also described (which extended from the kidney level to the bilateral femoral level) with a maximum diameter of 60.5 mm and generalized atheromatosis. By corroborating clinical, anamnestic, laboratory and imaging data, the case was diagnosed as moderately severe acute ischemic pancreatitis, pancreatic pseudocyst, abdominal aortic aneurysm, generalized atheromatosis. The pancreatic pseudocyst was resorbed in eight months. Surgery for the abdominal aneurysm was performed after the resorption of the pseudocyst. The patient died after aortic surgery because of a septic complication.
  
  
  CONCLUSIONS
  Ischemic pancreatitis is a rare condition but should be considered in a patient with upper abdominal pain and elevated amylase in the context of an abdominal aortic aneurysm and generalized atheromatosis.
authors.affiliation: 2nd Medical Department, Cluj-Napoca, Romania. ileanacocota@yahoo.com.
authors.forename: Ileana
authors.initials: I
authors.lastname: Cocota
authors.affiliation: Department of Clinical Imaging Ultrasound, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania. rbadea@umfcluj.ro.
authors.forename: Radu
authors.initials: R
authors.lastname: Badea
authors.affiliation: Heart Institute "Prof. Dr. Nicolae Stancioiu", "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania. tscridon@umfcluj.ro.
authors.forename: Traian
authors.initials: T
authors.lastname: Scridon
authors.affiliation: 2nd Medical Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania. ddumitrascu@umfcluj.ro.
authors.forename: Dan L
authors.initials: DL
authors.lastname: Dumitrascu
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000150:complications* / Q000601:surgery; D017809:Fatal Outcome; D006801:Humans; D007511:Ischemia / Q000150:complications*; D008297:Male; D010179:Pancreas / Q000098:blood supply*; D010192:Pancreatic Pseudocyst / Q000150:complications / Q000000981:diagnostic imaging; D010195:Pancreatitis / Q000209:etiology*; D058226:Plaque, Atherosclerotic / Q000150:complications; D011183:Postoperative Complications / Q000209:etiology*; D011859:Radiography; D018805:Sepsis / Q000209:etiology*