Venous gangrene and migratory thrombophlebitis associated with pancreatic carcinoma / 대한내과학회지

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.