Journals / Journal of Emergency Medicine Case Reports / 2025 / Cilt: 16 Sayı: 4

Do not ignore Walzel’s sign with Acut Severe Pancreatititis: A Mortal Chain of Complications with Multiple Organ Dysfunction Syndrome and Disseminated Intravascular Coagulation

Serpil Bayındır(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ELAZIĞ FETHİ SEKİN ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ)0000-0001-7250-7060
Alev Coşkun(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ELAZIĞ FETHİ SEKİN ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ)0000-0002-0742-3271
Muhammed Başpınar(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ELAZIĞ FETHİ SEKİN ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ)0009-0004-6100-0239
Fatma Karabulut(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ELAZIĞ FETHİ SEKİN ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ)0009-0009-7664-1836
Pages
157–160
Publication Date
2025-12-31
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

It is envisioned that early diagnosis in patients with severe AP with aggressive course may have a favorable effect on the clinical course and prognosis.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Introduction: This case report describes a patient with severe acute pancreatitis (AP) who presented with livedo reticularis (Walzel's sign), a rare cutaneous finding.
📊
Key Findings & Data:Case report: A 51-year-old woman presented to the emergency department with reticular skin lesions starting from the lower extremities and spreading throughout the body.
💡
Conclusion & Impact:It is envisioned that early diagnosis in patients with severe AP with aggressive course may have a favorable effect on the clinical course and prognosis.
🔬Design:Olgu Sunumu
📍Scope:Comprehensive Sample
⚙️Variables:Akut pankreatit · Livedo retikülaris · Walzel belirtisi

Abstract

Introduction: This case report describes a patient with severe acute pancreatitis (AP) who presented with livedo reticularis (Walzel's sign), a rare cutaneous finding. Case report: A 51-year-old woman presented to the emergency department with reticular skin lesions starting from the lower extremities and spreading throughout the body. Laboratory and radiologic investigations showed that she developed severe AP, multiple organ failure and disseminated intravascular coagulation. The patient's clinical course deteriorated rapidly and he died in cardiac arrest within approximately 10 hours. Conclusion: This case is presented to contribute to the literature and to point out that Walzel's sign characterized by livedo reticularis, a rare skin finding in severe AP, may be a clinical sign that may lead to early diagnosis. It is envisioned that early diagnosis in patients with severe AP with aggressive course may have a favorable effect on the clinical course and prognosis.

Özet

Giriş: Bu vaka sunumu, nadir bir deri bulgusu olan livedo retikülaris (Walzel belirtisi) ile başvuran şiddetli akut pankreatitli (AP) bir hastayı ele almaktadır. Vaka sunumu: 51 yaşındaki kadın hasta, acil servise alt ekstremitelerden başlayıp tüm vücuda yayılan retiküler formda cilt lezyonları ile başvurmuştur. Laboratuvar ve radyolojik incelemeler, hastada şiddetli AP, çoklu organ yetmezliği ve dissemine intravasküler koagülasyon geliştiğini göstermiştir. Hastanın klinik seyri hızlı bir şekilde kötüleşmiş ve yaklaşık 10 saat içinde kardiyak arrest sonucu kaybedilmiştir. Sonuç: Bu vaka şiddetli AP'de nadir görülen cilt bulgusu olan livedo retikülaris ile karakterize Walzel’s işaretinin erken tanıya götürebilecek klinik bir işaret olabileceğine dikkat çekmek ve literatüre katkıda bulunmak için sunulmuştur. Agresif seyirli şiddetli AP hastalarında erken tanı konulmasının klinik seyri ve prognozu olumlu yönde değiştirebilecek bir etki oluşturabileceği öngörülmüştür.

🔖

Cite This Article

Bayındır, S. (2025). Do not ignore Walzel’s sign with Acut Severe Pancreatititis: A Mortal Chain of Complications with Multiple Organ Dysfunction Syndrome and Disseminated Intravascular Coagulation. Journal of Emergency Medicine Case Reports, Cilt: 16 Sayı: 4, 157–160. https://doi.org/10.33706/jemcr.1673792

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (10)

  1. Zilio MB, Eyff TF, Azeredo-Da-Silva ALF, Bersch VP, Osvaldt AB. A systematic review and meta-analysis of theaetiology of acute pancreatitis. HPB (Oxford). 2019;21(3):259–267. doi:10.1016/j.hpb.2018.09.004
  2. Trikudanathan G, Wolbrink DRJ, vanSantvoort HC, Mallery S, Freeman M, Besselink MG. Current concepts in severe acute and necrotizing pancreatitis: an evidence-based approach. Gastroenterology. 2019;156(7):1994–2007.e3. doi:10.1053/j. gastro.2019.01.269
  3. Daniel M, Kamel M, Abdelsayed G. Severe acute pancreatitis with livedo reticularis: a rare cutaneous manifestation. Austin J Gastroenterol. 2024;11(1):1131
  4. Gould JW, Helms SE, Schulz SM, Stevens SR. Relapsing livedo reticularis in the setting of chronic pancreatitis. J Am Acad Dermatol. 1998;39(6):1035–1036. doi:10.1016/S0190- 9622(98)70346-0
  5. Miulescu R, Balaban DV, Sandru F, Jinga M. Cutaneous manifestations in pancreatic diseases—a review. J ClinMed. 2020;9:2611. doi:10.3390/jcm9092611
  6. Kashintsev AA, Kunda R, Proutski V. Early selective enteral feeding in combination with active decompression of duodenum in treatment of moderate and severe acute pancreatitis: a proof-of-concept clinical study. Pancreatology. 2024;24(7):1012–1020. doi:10.1016/j.pan.2024.09.013
  7. Wu M, Shi L, Zhang H, Liu H, Liu Y, Zhang W. Prognostic value of arterial lactate concentration in severe acute pancreatitis for 28-day mortality after hospital admission. PostgradMed J. 2022;134:210–216
  8. Yang Y, Du S, Yuan W, Kou Y, Nie B. Prolonged activated partial thromboplastin time predicts poor short-term prognosis in patients with acute pancreatitis: a retrospective cohort study. Clin Transl Sci. 2022;15(10):2505–2513. doi:10.1111/cts.13378
  9. Devani K, et al. Acute pancreatitis: trends in outcomes and the role of acute kidney injury in mortality-a propensitymatched analysis. Pancreatology. 2018;18(8):870–877. doi:10.1016/j.pan.2018.08.002
  10. Zhou J, Li Y, Tang Y, et al. Effect of acute kidney injury on mortality and hospitalstay in patients with severe acute pancreatitis. Nephrology (Carlton). 2015;20:485–491. doi:10.1111/nep.12429