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IanBoiskin,1 Martin P.SandIer,1 Arthur C.Fleischer,1 andWilliam A.NylanderThenumber ofpancreas transplantations performed inselected patients withseverediabetes mellitushasincreasedinrecent years.Technical complications aftersurgery arerelativelycommon andremainamajorobstacle tothesuccessoftheprocedure. According toHantoandSutherland [1],acutevenousthrombosis isthesecondmostcommon causeofgraftlossandusuallyoccurs inthefirstweekaftertrans-plantation. Successful thrombectomy hasnotbeenaccom-plished inanypatient; infarction occurs immediately afterthrombosis, andthediagnosis isnotmadeearlyenough toallowrevascularization.Perfusion scintigraphy isasensitive, albeitnonspecific in-dicatorofabnormal perfusion inthetransplanted organ[2].Ifthegraftisnotvisualized, arteriography isnecessary andistheprocedure ofchoiceforfurtherevaluation. Theabsenceofbloodflowisthought tosignifyvascular thrombosis andwarrants theremoval oftheallograft [i].Inarecentcase[3]inwhichduplex Doppler sonographywasusedincorrelation withtheradionuclide perfusion study,earlydiagnosis ofallograft renalveinthrombosis wasre-ported. Surgical correction wasdoneimmediately, andthetransplanted kidneywassalvaged.Wedescribe acaseinwhich,usingthesametwoproce-dures, wediagnosed anacute venous thrombosis inanallograft pancreas transplant.

Neonatal aortic thrombosis, once a rare entity, is now seen with increasing frequency as a complication of umbilical artery catheterization (UAC). Two studies used contrast aortography to demonstrate that the incidence of thrombosis in asymptomatic infants with indwelling UACs is greater than 90% [1 , 2]. Although these studies show that varying amounts of thrombus formation are usually present after catheterization, most of these thnomboses apparently resolve spontaneously without clinical sequelae. Occasionally, the aortic thrombosis progresses to occlusion, with a very high nonoperative mortality rate [3]. Recent advances in vascular surgery have made thrombectomy feasible in affected infants, and most can now be successfully managed by prompt emergency aortotomy [3, 4]. Sensitive, specific, and minimally invasive diagnostic methods are needed to help identify those neonates who require surgical intervention. This case report illustrates the relative roles of neal-time sonography, duplex pulsed Doppler sonognaphy, and radioisotope angiography in evaluating this problem.