Chirurgia (Bucur). 2021 Dec;116(6 Suppl):S5-S15.
Beside the common situations of upper gastrointestinal bleeding (GIB) managed by endoscopy, there are clinical situations when the endoscopic approach is limited by the amount of blood, the hemodynamic instability, the intermittent nature of bleeding and a proper diagnosis and treatment requires radiological interventional methods and even surgery. The pancreatic pathology is rarely considered as a possible cause for patients that presents in emergencies with GIB. The rupture of visceral artery aneurysms (VAAs), without underlying pancreatic pathology, should also be regarded in the differential diagnosis of GIB. Even the natural history of VAAs is not well understood, there is a potential risk of bleeding in the gastrointestinal tract, peritoneal cavity and retroperitoneal space, that can result in death. In this paper, we aim to review the rare causes of GIB focusing on pancreatic pathology and VAAs, unrevealed by the underlying pathology and presenting in the emergency department with bleeding symptoms and signs.
除了常见的可通过内镜治疗的上消化道出血（GIB）情况外，还有一些临床情况内镜方法受到出血量、血流动力学不稳定、出血间歇性以及正确诊断和治疗需要放射介入方法甚至手术的限制。胰腺病变很少被认为是 GIB 急诊患者的可能病因。内脏动脉动脉瘤（VAAs）破裂，没有潜在的胰腺病变，也应在 GIB 的鉴别诊断中考虑。即使 VAAs 的自然病史尚不清楚，但胃肠道、腹腔和腹膜后间隙存在出血的潜在风险，可导致死亡。本文旨在通过对以下内容的回顾，探讨 GIB 的罕见病因，重点关注胰腺病变和 VAAs，这些病因可能未被基础病理揭示，并以上消化道出血的症状和体征表现为急诊症状。
