This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Surgery
[{'content': 'Vascular complications of acute pancreatitis include the following except - \nSelect and explain. \nA. Splenic vein thrombosis, B. Splenic artery aneurysm, C. Gastroduodenal artery aneurysm, D. Middle colic artery thrombosis', 'role': 'user'}, {'content': 'Answer: D \nExplanation: Acute pancreatitis is rarely associated with arterial vascular complications.\nMC vessel affected: Splenic artery.\nOther vessels: Superior mesenteric, cystic, and gastroduodenal arteries.\n\nVascular Thrombosis\n\nPancreatic inflammation can produce vascular thrombosis.\nMC affected vessel: Splenic vein.\nIn severe cases, it can extend into the portal venous system.\nImaging demonstrates splenomegaly, gastric varices, and splenic vein occlusion.\nThrombolytics have been described in the acute early phase.\nMost patients can be managed with conservative treatment.\nRecurrent episodes of upper gastrointestinal bleeding caused by venous hypertension should be treated with splenectomy.\n\nPathogenesis\nIt has been proposed that pancreatic elastase damages the vessels, leading to pseudoaneurysm formation.\nClinical Features\n\nSpontaneous rupture\xa0results in massive bleeding.\nClinical manifestations include sudden onset of abdominal pain, tachycardia, and hypotension.\n\nTreatment\n\nIf possible, arterial embolization should be attempted to control the bleeding.\nRefractory cases require ligation of the affected vessel.\nThe mortality ranges from 28-56%.\nMC affected vessel in acute pancreatitis: Splenic artery (pseudoaneusysm formation).\nMC affected vessel leading to vascular thrombosis caused by acute pancreatitis: Splenic vein.', 'role': 'assistant'}]