An Atypical Case of Acute Pulmonary Embolism in a Sri Lankan Patient With Acute Severe Pancreatitis With Heterozygosity for the SPINK 1 Mutation.

Acute pancreatitis is a disease characterized by local destruction of the pancreatic gland due to premature activation of pancreatic enzymes within the acinar cells. Tissue damage can activate an inflammatory cascade, which can lead to systemic complications. Although vascular complications are uncommon, they significantly contribute to mortality and morbidity. Pulmonary embolism being an exceptionally rare complication of acute pancreatitis is reported in only a few cases, and cases of pulmonary embolism without associated deep vein thrombosis in the lower limbs are extraordinarily rare and unreported in the literature. This article presents the case of a 22-year-old Sri Lankan woman diagnosed with severe acute pancreatitis. On the fifth day of her illness, she developed sudden-onset dyspnea, and imaging revealed a large pulmonary artery embolism affecting the right pulmonary artery and segmental branches in the right lower lobe, with a normal venous duplex scan of the lower limbs. We started her on anticoagulation and supportive care for her acute severe pancreatitis. Her dyspnea and pancreatitis improved with time. She was later diagnosed as heterozygous for the serine peptidase inhibitor Kazal type 1 (SPINK 1) mutation.