title: [Haemorrhagic shock complicating acute pancreatitis].
abstract: BACKGROUND
  Acute pancreatitis may be accompanied by a number of complications. They include diffuse peritonitis, intra-abdominal and retroperitoneal abscesses, and severe haemorrhage. These complications are the cause of approximately 50% of all deaths in acute pancreatitis.
  
  
  METHODS
  A 33-year-old man was admitted to ITU with septic shock, due to acute pancreatitis and necrosis after multiple surgeries. On the fifth day after admission, his condition deteriorated due to respiratory distress and massive bleeding from the splenic region requiring surgical packing. On the next day, the bleeding became critical. More than 2000 mL of blood was evacuated from the peritoneal cavity, the bleeding site was re-packed, and the patient was transfused with RBCs, FFP and 0.04 mg kg(-1) of recombinant factor VIIa concentrate. This resulted in haemostasis, however the subsequent clinical course was complicated by septic shock, perforation of the transverse colon and peritonitis. The patient eventually recovered and was discharged home after 105 days in hospital.
  
  
  CONCLUSIONS
  Multifactorial management of acute pancreatitis is essential; in cases of severe haemorrhage, surgical packing and administration of recombinant factor VIIa concentrate are key components of successful treatment.
authors.affiliation: Klinika Anestezjologii i Intensywnej Terapii, Akademia Medyczna we Wrocławiu. w.duszynska@onet.eu
authors.forename: Wiesława
authors.initials: W
authors.lastname: Duszyńiska
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Lipińska-Gediga
authors.forename: Paweł
authors.initials: P
authors.lastname: Domosławski
authors.forename: Teresa
authors.initials: T
authors.lastname: Kaiser
authors.forename: Grazyna
authors.initials: G
authors.lastname: Durek
authors.forename: Wiktor
authors.initials: W
authors.lastname: Bednarz
mesh_terms: D000328:Adult; D001779:Blood Coagulation Factors / Q000627:therapeutic use; D016638:Critical Illness; D015942:Factor VIIa / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009102:Multiple Organ Failure / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery / Q000628:therapy; D019283:Pancreatitis, Acute Necrotizing / Q000150:complications* / Q000601:surgery / Q000628:therapy; D011994:Recombinant Proteins / Q000627:therapeutic use; D012422:Rupture, Spontaneous / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery / Q000628:therapy; D012771:Shock, Hemorrhagic / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery / Q000628:therapy; D012772:Shock, Septic / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D001779:Blood Coagulation Factors; D011994:Recombinant Proteins; C103587:recombinant FVIIa; D015942:Factor VIIa