Micković Sasa, Mitrović Miroslav, Stanković Nebojsa, Bezmarević Mihailo, Jovanović Milan, Mirković Darko, Tufegdzić Ivana, Micković Irena Nikolić
Military Medical Academy, Clinic for Abdominal and Endocrine Surgery, Belgrade, Serbia.
Vojnosanit Pregl. 2011 Jul;68(7):602-6. doi: 10.2298/vsp1107602m.
Pancreatic pseudocyst presented as pseudoaneurysm of the splenic artery is a potential serious complication in patients with chronic pancreatitis.
A 42-year-old male patient with a long-standing evolution of chronic pancreatitis and 8-year long evolution of pancreas pseudocyst was referred to the Military Medical Academy, Belgrade due to worsening of the general condition. At admission, the patient was cachectic, febrile, and had the increased values of amylases in urine and sedimentation (SE). After clinical and diagnostic examination: laboratory assessment, esophagogastroduodenoscopy (EGDS), ultrasonography (US), endoscopic ultrasonography (EUS), multislice computed scanner (MSCT) angiography, pseudoaneurysm was found caused by the conversion of pseudocyst on the basis of chronic pancreatitis. The patient was operated on after founding pancreatic pseudocyst, which caused erosion of the splenic artery and their mutual communication. Postoperative course was duly preceded without complications with one year follow-up.
Angiography is the most reliable and the safest method for diagnosing hemorrhagic pseudocysts when they clinically present as pseudoaneurysms. A potentially dangerous complication in the presented case was treated surgically with excellent postoperative results.
胰腺假性囊肿表现为脾动脉假性动脉瘤是慢性胰腺炎患者潜在的严重并发症。
一名42岁男性患者,患有慢性胰腺炎多年且胰腺假性囊肿已存在8年,因全身状况恶化被转诊至贝尔格莱德军事医学院。入院时,患者消瘦、发热,尿淀粉酶和血沉(SE)值升高。经过临床和诊断检查:实验室评估、食管胃十二指肠镜检查(EGDS)、超声检查(US)、内镜超声检查(EUS)、多层螺旋计算机断层扫描(MSCT)血管造影,发现假性动脉瘤是由慢性胰腺炎基础上的假性囊肿转变所致。发现胰腺假性囊肿导致脾动脉侵蚀并相互连通后,患者接受了手术。术后过程顺利,随访一年无并发症。
当出血性假性囊肿临床上表现为假性动脉瘤时,血管造影是诊断最可靠、最安全的方法。本病例中一种潜在的危险并发症通过手术治疗,术后效果良好。