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真性脾动脉瘤导致的胰源性血囊肿:上消化道大出血的罕见原因

Haemosuccus pancreaticus due to true splenic artery aneurysm: a rare cause of massive upper gastrointestinal bleeding.

作者信息

Sadhu S, Sarkar S, Verma R, Dubey Sk, Roy Mk

机构信息

Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, India.

出版信息

J Surg Case Rep. 2010 Jul 1;2010(5):4. doi: 10.1093/jscr/2010.5.4.

Abstract

"Haemosuccus pancreaticus" is an unusual cause of severe upper gastrointestinal bleeding and results from rupture of splenic artery aneurysm into the pancreatic duct. More commonly, it is a pseudoaneurysm of the splenic artery which develops as sequelae of pancreatitis. However, true aneurysm of the splenic artery without pancreatitis has rarely been incriminated as the etiologic factor of this condition. Owing to the paucity of cases and limited knowledge about the disease, diagnosis as well as treatment become challenging. Here we describe a 60-year-old male presenting with severe recurrent upper gastrointestinal bleeding and abdominal pain, which, after considerable delay, was diagnosed to be due to splenic artery aneurysm. Following an unsuccessful endovascular embolisation, the patient was cured by distal pancreatectomy and ligation of aneurysm.

摘要

“胰源性血囊肿”是严重上消化道出血的一种罕见病因,由脾动脉瘤破裂进入胰管所致。更常见的情况是,它是脾动脉假性动脉瘤,是胰腺炎的后遗症。然而,无胰腺炎的脾动脉真性动脉瘤很少被认为是该病的病因。由于病例稀少且对该疾病的了解有限,诊断和治疗都具有挑战性。在此,我们描述一名60岁男性,因严重反复上消化道出血和腹痛就诊,经过相当长的延迟后,被诊断为脾动脉瘤所致。在血管内栓塞治疗失败后,患者通过远端胰腺切除术和动脉瘤结扎术得以治愈。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb9e/3649121/117a40d67290/jscr-2010-5-4fig1.jpg

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