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胰腺炎:预防灾难性出血。

Pancreatitis: Preventing catastrophic haemorrhage.

机构信息

Richard PT Evans, Gunraj Pall, Russel's Hall Hospital, Dudley DY1 2HQ, United Kingdom.

出版信息

World J Gastroenterol. 2017 Aug 14;23(30):5460-5468. doi: 10.3748/wjg.v23.i30.5460.

Abstract

Pancreatitis represents nearly 3% of acute admissions to general surgery in United Kingdom hospitals and has a mortality of around 1%-7% which increases to around 10%-18% in patients with severe pancreatitis. Patients at greatest risk were those identified to have infected pancreatic necrosis and/or organ failure. This review seeks to highlight the potential vascular complications associated with pancreatitis that despite being relatively uncommon are associated with mortality in the region of 34%-52%. We examine the current evidence base to determine the most appropriate method by which to image and treat pseudo-aneurysms that arise as the result of acute and chronic inflammation of pancreas. We identify how early recognition of the presence of a pseudo-aneurysm can facilitate expedited care in an expert centre of a complex pathology that may require angiographic, percutaneous, endoscopic or surgical intervention to prevent catastrophic haemorrhage.

摘要

胰腺炎占英国医院普外科急性住院患者的近 3%,死亡率约为 1%-7%,在重症胰腺炎患者中上升至 10%-18%。风险最大的患者是那些被确定患有感染性胰腺坏死和/或器官衰竭的患者。本综述旨在强调与胰腺炎相关的潜在血管并发症,尽管这些并发症相对罕见,但与该地区 34%-52%的死亡率相关。我们检查了当前的证据基础,以确定最适合的成像和治疗方法,用于治疗由于胰腺急性和慢性炎症而导致的假性动脉瘤。我们确定了早期识别假性动脉瘤的存在如何能够促进在一个复杂病理的专家中心进行快速治疗,这可能需要血管造影、经皮、内镜或手术干预来防止灾难性出血。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02e9/5558110/a4d3f42ca6c9/WJG-23-5460-g001.jpg

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