Acute pancreatitis with Purtscher's retinopathy: case report and review of the literature

Campo, Salvatore; Gasparri, V.; Catarinelli, G.; Sepe, M.

doi:10.1016/s1590-8658(00)80338-2

Cited by 37 publications

(25 citation statements)

References 12 publications

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“…Later a similar finding was noted in cases related to various types of trauma, including seatbelt and airbag pressure, malar bone fracture, crush injury, and chest trauma [1-4]. Purtscher-like retinopathy is seen in patients with acute pancreatitis, systemic lupus erythematous, HELLP syndrome, and renal failure, as well as in patients with adenocarcinoma of the pancreas with no relation to trauma [5-8]. …”

Section: Discussionmentioning

confidence: 59%

Purtscher-like retinopathy following valsalva maneuver effect: case report

2011

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IntroductionPurtscher's retinopathy is a rare condition that is noted in cases related to various types of trauma. The characteristic finding in the fundus is the presence of multiple Purtscher flecken. Purtscher-like retinopathy has a similar presentation in the fundus, but without an association with trauma.Case presentationA 43-year old Malay man presented with a sudden onset of central foggy vision in the left eye after holding his breath for two minutes while catching a falling object. It was not associated with floaters, flashes of light, or head trauma. His vision in the right eye was 6/6, and in his left eye it was finger counting. He had bilateral temporal sub-conjunctival hemorrhages. An examination of his left fundus revealed multiple white cotton wool spots and dot-blot retinal hemorrhages with diffuse retinal edema at the posterior pole. His right fundus was noted to have only mild temporal peri-papillary edema associated with a few dot-blot hemorrhages. Fundus fluorescein angiography showed good arterial perfusion and no evidence of leaking or neo-vascularization. A diagnosis of Purtscher-like retinopathy was made, and the patient was treated with indomethacin tablets for six weeks. At his six-week follow-up examination, his left eye visual acuity had improved to 6/12. His bilateral sub-conjunctival hemorrhage had resolved. His left fundus showed residual multiple cotton wool spots and reduced retinal edema.ConclusionsTreatment with non-steroidal anti-inflammatory drugs seems to be effective in reducing edema in patients with Purtscher-like retinopathy.

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Section: Discussionmentioning

confidence: 59%

Purtscher-like retinopathy following valsalva maneuver effect: case report

2011

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“…In the particular case of Purtscher-like retinopathy associated with acute pancreatitis, it has been proposed that pancreatic damage causes release of proteolytic enzymes into the systemic circulation with subsequent activation of complement cascade and the formation of C5a-induced leukocyte, platelet, and fibrin aggregate that will cause retinal embolization and ischemia, but the true mechanism has not been established yet [10][11][12].…”

Section: Discussionmentioning

confidence: 99%

Purtscher-like Retinopathy

Liang

Zhou

2017

The American Journal of the Medical Sciences

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Purtscher-like retinopathy is associated with retinal hemorrhages and ischaemia probably due to the complement-mediated leukoembolization. It is a rare and severe angiopathy found in conditions such as acute pancreatitis. Case. We present a case of a 53-year-old man who presented with a Purtscher-like retinopathy associated with the development of acute pancreatitis in the context of a Klatskin tumour (a hilar cholangiocarcinoma). The ophthalmologic evaluation revealed the best corrected visual acuity (BCVA) of 20/32 in the right eye (RE) and of 20/40 in the left eye (LE); biomicroscopy of anterior segment showed scleral icterus and fundoscopy revealed peripapillary cotton-wool spots, optic disc edema, and RPE hypo-and hyperpigmentation in the middle peripheral retina in both eyes with an intraretinal hemorrhage in the LE. 15 months after the initial presentation, without ophthalmological treatment, there was an improvement of BCVA to 20/20 in both eyes and optical coherence tomography (OCT) revealed areas of reduction of retinal nerve fiber layer thickness corresponding to the previous cotton-wool spots. Conclusion. Purtscher-like retinopathy should not be neglected in complex clinical contexts. Its unclear pathophysiology determines an uncertain treatment strategy, but a meticulous follow-up is compulsory in order to avoid its severe complications.

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“…It has varied presentations, ranging from isolated intravascular thrombosis to disseminated intravascular coagulation. Rarely, microemboli can result in occlusion of the retinal arterioles with subsequent blindness [2, 5]. Acute pancreatitis has also been reported in causative association with thrombotic thrombocytopenic purpura-hemolytic uremic syndromes and thrombotic microangiopathy, resulting in acute renal failure [6, 7].…”

Section: Discussionmentioning

confidence: 99%

Arterio-Pancreatic Syndrome

Lee

Sebastian

2011

Case Rep Gastroenterol

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Acute pancreatitis is a single-organ disorder that has multi-organ sequelae. As a result, it can have varied presentations. Acute pancreatitis presenting as acute limb ischemia is rare. We present a patient with acute pancreatitis presenting with bilateral lower limb ischemia. The episode of acute pancreatitis resolved but the acute lower limb ischemia precipitated as the pancreatitis progressed, and necessitated bilateral above-knee amputations. We review the literature and discuss the pathogenesis of such a phenomenon.

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Acute pancreatitis with Purtscher's retinopathy: case report and review of the literature

Cited by 37 publications

References 12 publications

Purtscher-like retinopathy following valsalva maneuver effect: case report

Purtscher-like retinopathy following valsalva maneuver effect: case report

Purtscher-like Retinopathy

Arterio-Pancreatic Syndrome

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