Koren M, Kinova S, Bedeova J, Javorka V, Kovacova E, Kekenak L
1st Department of Internal Medicine, Faculty of Medicine, University Comenius, Bratislava, Slovakia.
Bratisl Lek Listy. 2008;109(1):37-41.
In this study, authors describe a rare case of a 40-year old patient with a history of chronic pancreatitis due to ethanol abuse, repeatedly hospitalized for intermittent bleeding into gastrointestinal tract (GIT). The sources of bleeding were pseudoaneurysms of the peripancreatic arteries (gastroduodenal artery, right hepatic artery) bleeding into GIT via pancreatic duct. This type of bleeding is referred as hemosuccus pancreaticus and belongs to a rare form of bleeding into upper GIT. Development of each pseudoaneurysm was monitored with a 6 month time interval. The diagnosis was established using endoscope, Doppler ultrasound and CT angiography. During the therapeutic process, while stopping bleeding, two different radiological interventions were used. In pseudoaneurysm of gastroduodenal artery, hemostasis was achieved using selective transcatheter arterial embolization (TAE) with steel coils. In the second intervention, a stent was inserted into vascular lesion. In the discussion, authors review the problems of hemosuccus pancreaticus, epidemiology, symptoms, diagnostic and possible therapeutic approaches (Fig. 3, Ref. 31). Full Text (Free, PDF) www.bmj.sk.
在本研究中，作者描述了一例罕见病例，一名40岁患者有因乙醇滥用导致慢性胰腺炎的病史，因胃肠道间歇性出血而反复住院。出血来源是胰周动脉（胃十二指肠动脉、肝右动脉）的假性动脉瘤，通过胰管向胃肠道出血。这种类型的出血被称为胰源性门脉高压性胃肠出血，属于上消化道出血的一种罕见形式。每隔6个月监测每个假性动脉瘤的发展情况。通过内镜、多普勒超声和CT血管造影进行诊断。在治疗过程中，在止血的同时，采用了两种不同的放射学干预措施。对于胃十二指肠动脉假性动脉瘤，使用钢圈进行选择性经导管动脉栓塞术（TAE）实现止血。在第二次干预中，将支架插入血管病变处。在讨论中，作者回顾了胰源性门脉高压性胃肠出血的问题、流行病学、症状、诊断及可能的治疗方法（图3，参考文献31）。全文（免费，PDF）www.bmj.sk 。
