Background: Severe acute pancreatitis (SAP) can cause excessive systemic inflammation and blood hypercoagulability, resulting in various venous thrombosis-related complications. Few studies have examined the association between pulmonary embolism (PE) and SAP. We retrospectively analyzed the clinical characteristics of patients who were diagnosed with SAP complicated with PE, in order to improve the early diagnosis and treatment of such diseases.

Methods: Patients who were diagnosed with SAP admitted to our hospital between January 2017 and December 2021 were included in this study. The clinical data of 15 cases of SAP complicated with PE were retrospectively analyzed.

Results: The average age of the 15 patients was 55.6±21.6 years. In terms of the etiology of pancreatitis, 3 cases were alcoholic, 5 cases were biliary, 6 cases were hypertriglyceridemic, and 1 case was idiopathic. The indexes of white blood cells, C-reactive protein (CRP), fibrinogen, D-dimer, and others were obviously high, and blood oxygen pressure was obviously low. The occurrence site of PE was mainly branch embolism. All patients underwent pulmonary artery computed tomography angiography (CTA), the results of 4 cases were negative, the diagnosis of PE was confirmed using pulmonary ventilation and perfusion imaging.

Conclusions: PE is a rare but fatal complication of SAP. The clinical manifestations may be atypical. If there is clinical suspicion, further examination should be conducted promptly to confirm the diagnosis. Early detection and treatment should be conducted to reduce the risk of sudden death.