Herrera-Fernández Francisco Antonio, Palomeque-Jiménez Antonio, Serrano-Puche Félix, Calzado-Baeza Salvador Francisco, Reyes-Moreno Montserrat
Servicio de Cirugía General y Digestiva, Hospital Santa Ana, Motril. Granada, Spain.
Servicio de Radiología, Hospital Santa Ana, Motril. Granada, Spain.
Cir Cir. 2014 Sep-Oct;82(5):551-5.
Bleeding from a pancreatic pseudocyst is a severe complication after pancreatitis that can lead to a massive gastrointestinal blood loss. Pseudocyst rupture into the stomach is an unusual complication.
We report the case of a 34-year-old woman with a history of alcoholism and a pancreatic pseudocyst. One year after follow-up of her pseudocyst, she arrived at the emergency room with an episode of upper gastrointestinal bleeding. An upper digestive endoscopy showed active bleeding in the subcardial fundus, which could not be endoscopically controlled. Abdominal angio-CT confirmed the diagnosis of a splenic artery pseudoaneurysm in close contact with the back wall of the stomach, as well as a likely fistulization of it. The patient was urgently operated and a distal splenopancreatectomy and fistulorrhaphy was performed.
The rupture of a splenic artery pseudoaneurysm may rarely present as upper gastrointestinal bleeding. This may be lethal if not urgently treated.
胰腺假性囊肿出血是胰腺炎后的一种严重并发症，可导致大量胃肠道失血。假性囊肿破入胃是一种罕见的并发症。
我们报告一例34岁有酗酒史和胰腺假性囊肿的女性病例。对其假性囊肿进行随访一年后，她因上消化道出血发作而到急诊室就诊。上消化道内镜检查显示贲门底部有活动性出血，内镜无法控制。腹部血管CT证实诊断为与胃后壁紧密接触的脾动脉假性动脉瘤，以及可能存在的瘘管形成。患者紧急接受手术，进行了远端脾胰切除术和瘘管修补术。
脾动脉假性动脉瘤破裂很少表现为上消化道出血。如果不紧急治疗，这可能是致命的。
