Korean J Med.  2007 Feb;72(2):226-230.

Venous gangrene and migratory thrombophlebitis associated with pancreatic carcinoma

Affiliations
  • 1Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea. leehy@cnu.ac.kr

Abstract

It is a common belief that pancreatic carcinoma has an inherent and unique ability to induce hypercoagulable diathesis that leads to clinically significant thrombosis. The reported incidences of disease range from 17% to 57%. Thromboembolic disease is causally associated with an intrinsic hypercoagulable state. Pancreatic cancer cells activate platelets and these express several procoagulant factors, including tissue factor and thrombin. There are a variety of clinical presentations, include deep vein thrombosis, migratory thrombophlebitis, pulmonary embolism, disseminated intravascular coagulation, portal or superior mesenteric vein thrombosis, and extremity ischemia. Venous gangrene is a very unusual and severe form of venous thrombosis of an extremity, and this hasn't yet been reported in Korea. We report here on a case with repeated deep vein thrombosis that was associated with pancreatic carcinoma. Despite of aggressive treatment with low molecular heparin and oral anticoagulant warfarin, the repeated thrombosis was aggravated to venous gangrene of the lower extremity.

Keyword

Gangrene; Deep vein thrombosis; Pancreatic ductal; Carcinoma

MeSH Terms

Disease Susceptibility
Disseminated Intravascular Coagulation
Extremities
Gangrene*
Heparin
Incidence
Ischemia
Korea
Lower Extremity
Mesenteric Veins
Pancreatic Neoplasms
Pulmonary Embolism
Thrombin
Thrombophlebitis*
Thromboplastin
Thrombosis
Venous Thrombosis
Warfarin
Heparin
Thrombin
Thromboplastin
Warfarin
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