Bosman C, Sanhueza M, Schnettler D, Rossi R, Whittle C, Valderrama R
Facultad de Medicina de la Universidad de Chile.
Rev Med Chil. 2001 Jan;129(1):81-5.
We report a 52 year old man with a pancreatic pseudocyst, that was admitted with severe abdominal pain, severe vomiting, fever and malaise. The clinical picture was considered secondary to a pseudocyst infection and the patient was operated, draining the infected cyst performing a necrosis surgery and pancreatojejunostomy. Forty eight hours after the operation, an ostomy bleeding was detected. A upper mesenteric artery angiography showed two pseudoaneurysms in the gastroduodenal artery, that were embolized. Bleeding stopped initially, but seven days later, it reappeared. The patient was subjected to an emergency pancreatoduodenectomy. Postoperative evolution was uneventful and the patient was discharged two weeks later. Spontaneous bleeding of pseudoaneurysms secondary to chronic pancreatitis is a complication with a 15 to 40% mortality that must be bore in mind.
我们报告一名52岁患有胰腺假性囊肿的男性，因严重腹痛、剧烈呕吐、发热和不适入院。临床表现被认为是假性囊肿感染所致，患者接受了手术，对感染的囊肿进行引流，实施坏死组织清除术和胰空肠吻合术。术后48小时，发现造口出血。肠系膜上动脉血管造影显示胃十二指肠动脉有两个假性动脉瘤，对其进行了栓塞。出血最初停止，但7天后再次出现。患者接受了急诊胰十二指肠切除术。术后恢复顺利，患者两周后出院。慢性胰腺炎继发假性动脉瘤的自发性出血是一种并发症，死亡率为15%至40%，必须予以重视。
