Araki Ken-ichiro, Shimura Tatsuo, Watanabe Akira, Kobayashi Tsutomu, Suzuki Hideki, Suehiro Taketoshi, Kuwano Hiroyuki
Department of General Surgical Science (Surgery I), Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi-shi, Gunma 371-8511, Japan.
Hepatogastroenterology. 2009 Sep-Oct;56(94-95):1411-3.
The successful management of gastric bleeding from a pseudocyst with a pseudoaneurysm of the splenic artery is reported here. A 62-year-old male patient was referred to our hospital with a complaint of hematomesis. On a computed tomography and an abdominal angiography, it was evident that he was actively bleeding from a splenic pseudoaneurysm caused by a pancreatic pseudocyst. A transcathetheral arterial embolization (TAE) was performed on the splenic pseudoaneurysm to control bleeding. After the TAE, we resected the pancreatic pseudocyst by distal pancreatectomy with partial gastrectomy. Gastrointestinal bleeding from a pseudoaneurysm caused by a pancreatic pseudocyst is a rare, but sometimes lethal, complication. As only conservative therapy or TAE often results in lethal re-bleeding, we propose to perform elective surgery after TAE.
本文报道了脾动脉假性动脉瘤伴发假性囊肿所致胃出血的成功治疗案例。一名62岁男性患者因呕血症状转诊至我院。经计算机断层扫描和腹部血管造影检查发现，他正因胰腺假性囊肿引发的脾假性动脉瘤而出现活动性出血。对脾假性动脉瘤实施了经导管动脉栓塞术（TAE）以控制出血。TAE术后，我们通过远端胰腺切除术联合部分胃切除术切除了胰腺假性囊肿。胰腺假性囊肿引起的假性动脉瘤导致的胃肠道出血是一种罕见但有时会致命的并发症。由于单纯保守治疗或TAE常常会导致致命性再出血，我们建议在TAE术后进行择期手术。
