Shah Amir Ali, Charon Jean Pierre
Department of Gastroenterology and Hepatology, Crosshouse Hospital, Kilmarnock, UK.
Department of Radiology, Ayr Hospital, Ayr, UK.
J Pak Med Assoc. 2015 Jun;65(6):669-71.
Haemosuccus Pancreaticus is defined as upper gastro intestinal (GI) bleeding from the ampula of vater via the pancreatic duct. It is most commonly associated with pancreatic inflammation, erosion of the pancrease by aneurysm or pseudo-aneurysm of the splenic artery. We report a 69 year old man with previous history of acute pancreatitis who was admitted with recurrent haematemesis. Initial upper GI endocopy was normal, while admitted, he collapse with abdominal pain and hypotension. He was resuscitated with blood and intravenous fluid. Repeat upper GI endocopy showed fresh blood in the duodenum, but no active bleeding site was demonstrated. An urgent coeliac axis CT angiogram was done which showed an splenic artery pseudo-aneurysm, which was successfully embolized. Patient is well 9 months after the procedure. This case highlights the importance of considering coeliac axis CT angiogram as part of investigation for obscure GI bleeding.
胰源性出血被定义为经胰管从 Vater 壶腹引起的上消化道（GI）出血。它最常与胰腺炎症、脾动脉动脉瘤或假性动脉瘤对胰腺的侵蚀有关。我们报告一名 69 岁男性，既往有急性胰腺炎病史，因反复呕血入院。初次上消化道内镜检查正常，入院时，他因腹痛和低血压而休克。通过输血和静脉输液进行复苏。再次上消化道内镜检查显示十二指肠内有新鲜血液，但未发现活动性出血部位。进行了紧急腹腔动脉 CT 血管造影，显示脾动脉假性动脉瘤，该动脉瘤已成功栓塞。术后 9 个月患者情况良好。该病例强调了将腹腔动脉 CT 血管造影作为不明原因 GI 出血检查一部分的重要性。
