Ryu Kyunghwa, Hong Seong Sook, Cha Hwajin, Hwang Jiyoung, Lee EunJi, Cho Young Deok, Chang Yun-Woo, Kim Yong Jae
Department of Radiology, Soonchunhyang University Seoul Hospital, Yongsan-gu, Seoul, Korea.
Digestive Disease Center and Research Institute, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Yongsan-gu, Seoul, Korea.
Rev Assoc Med Bras (1992). 2019 Feb;65(2):123-126. doi: 10.1590/1806-9282.65.2.123.
Hemorrhagic pseudocysts with pseudoaneurysms are a rare and fatal complication of chronic pancreatitis due to the erosion of pancreatic to peripancreatic arteries. The timing of the rupture cannot be accurately predicted, but prompt diagnosis and management are essential to prevent further bleeding. We describe the case of a 68-year-old man who presented acute epigastric pain and anemia and had a history of chronic pancreatitis with a pseudocyst. A biliary and pancreas MRI showed an enlarged size of a known pancreatic pseudocyst with internal high signal intensity material. Color-Doppler ultrasonography showed pulsating signals in the pseudocyst, and our final diagnosis was a pseudoaneurysm in the pancreatic hemorrhagic pseudocyst. The pseudoaneurysm was successfully treated with coil embolization of the feeding artery. We report this case of a rare complication of chronic pancreatitis to show that color-Doppler ultrasound is a non-invasive and effective diagnostic tool for pseudoaneurysm, which enables early detection and prompt treatment without the need for invasive diagnostic modalities.
伴有假性动脉瘤的出血性假性囊肿是慢性胰腺炎的一种罕见且致命的并发症，系胰腺至胰周动脉受侵蚀所致。破裂时间无法准确预测，但及时诊断和处理对于防止进一步出血至关重要。我们报告一例68岁男性患者，其出现急性上腹部疼痛和贫血，有慢性胰腺炎伴假性囊肿病史。腹部磁共振成像显示已知的胰腺假性囊肿增大，内部有高信号强度物质。彩色多普勒超声显示假性囊肿内有搏动性信号，最终诊断为胰腺出血性假性囊肿内假性动脉瘤。通过对供血动脉进行弹簧圈栓塞成功治疗了假性动脉瘤。我们报告这例慢性胰腺炎的罕见并发症病例，以表明彩色多普勒超声是一种用于诊断假性动脉瘤的非侵入性有效诊断工具，可实现早期检测并及时治疗，无需进行侵入性诊断方法。
