Krejcí T, Hoch J, Leffler J
Chirurgická klinika 2. LF UK a FN Motol, Praha.
Rozhl Chir. 2003 Aug;82(8):413-7.
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.
与慢性胰腺炎相关的胰腺假性囊肿或假性动脉瘤出血的死亡率很高。诊断方法包括血管造影和增强CT；治疗主要基于经皮经血管栓塞术（PTE）和手术。保守治疗的死亡率高达90%。病例报告描述了一名44岁慢性胰腺炎患者因胃十二指肠动脉受侵蚀导致胰腺假性囊肿大量出血。假性囊肿自发穿孔至十二指肠导致失血性休克，需要紧急手术。通过纵向胃十二指肠切开术和经十二指肠壁进行假性囊肿剥离，得以确定出血血管。本文回顾了一些与慢性胰腺炎出血并发症相关的诊断和治疗问题，以及近期文献中发表的信息。
