Camishion R C, Pello M J, Spence R K, Alexander J B, Atabek U M, Kuroda K
Department of Surgery, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, Cooper Hospital/University Medical Center, Camden.
Surgery. 1992 Jan;111(1):86-9.
Gastrointestinal tract hemorrhage from rupture of the splenic artery into the pancreatic duct is unusual. This obscure cause of intermittent gastrointestinal tract bleeding should be suspected when the more common causes of bleeding have been ruled out. Duodenoscopy carried out during active hemorrhage may reveal blood coming from the papilla of Vater. Coeliac arteriography will show the pathognomonic findings and confirm the diagnosis. We have treated three patients who had chronic pancreatitis and who developed pseudocyst formation and pseudoaneurysms of the splenic artery. The pseudoaneurysm ruptured into the duct of Wirsung, causing obscure upper-gastrointestinal bleeding. Treatment was distal pancreatectomy and splenectomy, including the pseudoaneurysm and pseudocyst. A review of the literature suggests that three different types of bleeding into the pancreatic duct can occur. The cause of each is described.
脾动脉破裂进入胰管导致胃肠道出血并不常见。当排除了更常见的出血原因后，应怀疑这种隐匿的间歇性胃肠道出血病因。在活动性出血期间进行十二指肠镜检查可能会发现血液从十二指肠乳头流出。腹腔动脉造影将显示特征性表现并确诊。我们治疗了3例患有慢性胰腺炎并形成假性囊肿和脾动脉假性动脉瘤的患者。假性动脉瘤破裂进入胰管，导致隐匿性上消化道出血。治疗方法是远端胰腺切除术和脾切除术，包括切除假性动脉瘤和假性囊肿。文献回顾表明，可能发生三种不同类型的血液进入胰管的情况。每种情况的病因都有描述。
