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KMID : 0882420070720020226
Korean Journal of Medicine
2007 Volume.72 No. 2 p.226 ~ p.230
Venous gangrene and migratory thrombophlebitis associated with pancreatic carcinoma
Kim Yeon-Soo

Heo Won-Seok
Chae Kyung-Hoon
Kim Seok-Hyun
Sung Jae-Kyu
Lee Byung-Seok
Lee Heon-Young
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
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