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胰源性腹水所致危及生命的上消化道出血:一例报告

Life-Threatening Upper Gastrointestinal Hemorrhage in Hemosuccus Pancreaticus: A Case Report.

作者信息

Joshi Amey, Ca Jayashankar, Gada Lakshmi Meghana, K R Shruthi, Chaitra Kolli

机构信息

General Medicine, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, IND.

Internal Medicine, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, IND.

出版信息

Cureus. 2022 Apr 7;14(4):e23934. doi: 10.7759/cureus.23934. eCollection 2022 Apr.

Abstract

Hemosuccus pancreaticus (HP) is a rare cause of upper gastrointestinal bleeding caused by bleeding from the ampulla of Vater into the duodenum. HP most commonly results from a rupture of pseudoaneurysms secondary to chronic pancreatitis. The low incidence of HP and the wide spectrum of its clinical presentation poses diagnostic challenges. We present a case of a 39-year-old male with acute-on-chronic pancreatitis resulting in HP and obstructive jaundice due to pancreatic pseudocyst with secondary hematoma. This case highlights the rare occurrence of hypovolemic shock due to massive hemorrhage in HP and the successful management with prompt cardiovascular support and angiographic coil embolization of a bleeding pancreatic pseudoaneurysm.

摘要

胰源性腹水(HP)是由 Vater 壶腹出血进入十二指肠导致上消化道出血的一种罕见病因。HP 最常见于慢性胰腺炎继发假性动脉瘤破裂。HP 的低发病率及其广泛的临床表现给诊断带来了挑战。我们报告一例 39 岁男性,患有慢性胰腺炎急性发作,导致 HP 以及因胰腺假性囊肿伴继发性血肿引起的梗阻性黄疸。该病例突出了 HP 因大量出血导致低血容量性休克的罕见情况,以及通过及时的心血管支持和对出血性胰腺假性动脉瘤进行血管造影线圈栓塞的成功治疗。

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