RESUMO
We describe the case of a female patient with severe acute pancreatitis of biliary origin who presented with clinical deterioration. A thrombosis of the superior mesenteric artery and hepatic artery was identified as the cause, thus creating a rare vascular complication. She was taken for pharmacological and mechanical thrombectomy, with the subsequent death of the patient. Arterial vascular complications are an entity little recognized in the medical literature; they have a high mortality rate and pose a significant diagnostic and therapeutic challenge.
Se describe el caso de una paciente femenina con pancreatitis aguda grave de origen biliar quien presentó deterioro clínico, y como causa se identificó una trombosis de arteria mesentérica superior y arteria hepática, de modo que se configuró una complicación vascular poco frecuente. Fue llevada a trombectomía farmacológica y mecánica, con el posterior deceso de la paciente. Las complicaciones vasculares arteriales son una entidad poco reconocida en la literatura médica, tienen una alta tasa de mortalidad y suponen un reto diagnóstico y terapéutico importante.
RESUMO
Carcinomatosis of the bone marrow is a rare clinical condition characterized by diffuse tumor infiltration of the bone marrow accompanied by hematological abnormalities, including thrombotic microangiopathy (TMA) and disseminated intravascular coagulation (DIC). In patients with gastric carcinoma, this association is infrequent. Below we present a case of a 19-year-old female patient with no known pathological history who presented with upper digestive tract bleeding. Upon examination, anemia and thrombocytopenia were documented, with schistocytes in the peripheral blood smear and prolonged coagulation times. Endoscopic studies indicated a lesion in the Borrmann IV gastric body, and the bone marrow biopsy showed the presence of signet ring cells. Because there was no possibility of systemic therapy, the patient died during hospitalization. This case contributes to the medical literature by describing an unusual presentation of a very frequent pathology.