Belo Angelica C, Grabowski Eugene W, Zhang Chi, Longworth David L, Desilets David J
Baystate Medical Center, Tufts University School of Medicine, Springfield, MA 01199, USA.
JOP. 2007 Jul 9;8(4):429-32.
Hemosuccus pancreaticus is an uncommon cause of upper gastrointestinal bleeding. Chronic infection of the pancreas with Brucellosis causing hemosuccus pancreaticus has not been previously reported.
We describe a case of a 75-year-old man presenting with a pancreatic mass and hemosuccus pancreaticus secondary to chronic pancreatic brucellosis. Polymerase chain reaction analysis of the pancreatic tissue was positive for brucella after an initial positive serology. ERCP revealed bleeding from the pancreatic duct. Computed tomography scans of the abdomen demonstrated an enlarging pancreatic mass. Endoscopic ultrasound showed a cystic mass in the body of the pancreas. Fine needle aspiration revealed granulomata. Selective mesenteric angiogram failed to reveal the source of bleeding. The patient eventually underwent pancreatic resection with resolution of symptoms.
This is the first case of hemosuccus pancreaticus due to chronic pancreatic brucellosis reported in medical literature.
胰源性出血是上消化道出血的一种罕见原因。此前尚未有布鲁氏菌病慢性感染胰腺导致胰源性出血的报道。
我们描述了一例75岁男性患者，因慢性胰腺布鲁氏菌病出现胰腺肿块和胰源性出血。胰腺组织的聚合酶链反应分析在血清学初检呈阳性后，布鲁氏菌检测也呈阳性。内镜逆行胰胆管造影显示胰管出血。腹部计算机断层扫描显示胰腺肿块增大。内镜超声显示胰腺体部有一个囊性肿块。细针穿刺显示有肉芽肿。选择性肠系膜血管造影未能显示出血来源。患者最终接受了胰腺切除术，症状得以缓解。
这是医学文献中报道的首例因慢性胰腺布鲁氏菌病导致的胰源性出血病例。
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