ATHEROMATOUS EMBOLIZATION RESULTING IN ACUTE-PANCREATITIS AFTER CARDIAC-CATHETERIZATION AND ANGIOGRAPHIC STUDIES

Acute pancreatitis has a spectrum from mild disease to severe organ de struction resulting in multiple system organ failure. In this study, w e report data from 21680 discharge summaries during a 10-year period o f patients who had undergone transabdominal angiographic procedures in whom the diagnosis of pancreatitis was noted in the discharge coding. We detected 39 patients in whom pancreatitis was coded during the sam e hospitalization, but only nine patients had no other risk factors fo r pancreatitis other than the temporal relation with the angiographic procedure. Three of these nine patients died of complications caused b y pancreatitis. All of the patients with poor outcomes in this report fulfilled more than three Ranson criteria within 48 hours of the origi nal angiographic procedure. Abdominal imaging with ultrasound or compu ted tomography was abnormal in all the patients who fulfilled more tha n three Ranson criteria. The histology from the surgical procedures or the autopsies performed on the three patients who died showed extensi ve cholesterol embolization primarily to the visceral organs. Extensiv e pancreatic necrosis was evident in these patients. We conclude that acute pancreatitis after transabdominal angiographic procedures is a r are but a potential fatal event. The prognosis from this event is part ially predicted by the Ranson criteria that are evident within the fir st 48 hours.