Duodenal obstruction occurs in 12% of all cases of chronic pancreatitis and 25% cases operated for CBD obstruction also have duodenal obstruction. It can occur both due to the inflamatory mass and pseudocyst. patient has history of long standing nausea and vomiting. Endoscopy shows a concave extraluminal impression without mucosal involvement. Conservative treatment should be given for 2 weeks only
4% of patients with chronic pancreatitis have ascites and 12% with pancreatic pseudocyst develop pancraetic ascites. After making a diagnosis, ERCP should be done for defining the site of leak and going for a therapeutic procedue such as endoscopic stenting. Simultaneous use of octreotide, diuretics and repeated paracentesis also helps.
Surgery is not the primary treatment and is indicated when medical management fails, or despite adequate attempt asictes persists or recurs.
EPH or extrahepatic portal hypertension is the most common vascular complication of chronic pancreatitis. Any part of splenomesentericoportal venous axis may be involved resulting in either occlusive or non occlusive portal hypertension
Splenic vein is the most frequently involved
Common causes of venous thrombosis are
Inflamatory process causing danage to vessel wall with vasospasm, venous stasis and thrombosis