[Massive hemorrhage from a pancreatic pseudocyst into the duodenum].
Pancreatic pseudocyst or pseudoaneurysm bleeding related to chronic pancreatitis is associated with high mortality. Diagnostics includes angiography and contrast CT; therapy is based mainly on percutaneous transvascular embolisation (PTE) and surgery. Mortality burden related to conservative approach is up to 90%. Case report describes massive pancreas pseudocyst bleeding from erosion-affected arteria gastroduodenalis in 44-years-old patient with chronic pancreatitis. Spontaneous pseudocyst perforation into the duodenum caused hemorrhagic shock with necessity of urgent surgery. Identification of bleeding vessel was enabled thanks to longitudinal gastroduodenotomy and pseudocyst dissection through duodenum wall. Article reminds some diagnostics and therapeutics issues related to chronic pancreatitis complications with bleeding as well as information published in recent literature.
Krejcí
T
T
Chirurgická klinika 2. LF UK a FN Motol, Praha. k.tom@atlas.cz
Hoch
J
J
Leffler
J
J
D000328:Adult; D002908:Chronic Disease; D004386:Duodenum; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006470:Hemorrhage / Q000150:complications*; D006801:Humans; D008297:Male; D010192:Pancreatic Pseudocyst / Q000150:complications*; D019512:Pancreatitis, Alcoholic / Q000150:complications; D012422:Rupture, Spontaneous