Trehub Yevhenii, Vasiliev Oleg, Malovanna Anna
Department of Liver, Pancreatic Tumors and Oncovascular Surgery, National Cancer Institute, 33/43 Lomonosova st, Kyiv 03022, Ukraine.
Department of Oncology, Institute of Postgraduate Education, O.O. Bogomolets National Medical University, 36 Peremohy av, Kyiv 02000, Ukraine.
Radiol Case Rep. 2022 Jun 27;17(9):3142-3146. doi: 10.1016/j.radcr.2022.05.066. eCollection 2022 Sep.
Postpancreatectomy hemorrhage (PPH) is a severe complication of pancreatic surgery. This condition often develops on the background of pancreatic fistula. In our report, we demonstrate an unusual case of spontaneous cessation of severe postpancreatectomy common hepatic artery (СHA) hemorrhage after distal pancreatectomy in a patient with celiac artery stenosis (CAS). A 64-year-old male diagnosed with pancreatic tail tumor underwent extended distal pancreatectomy. He developed pancreatic fistula and was discharged with an abdominal drain, and was readmitted with severe postpancreatectomy hemorrhage from a pseudoaneurysm of the CHA. The bleeding stopped spontaneously due to CHA thrombosis. The patient developed no ischemic symptoms. Spontaneous severe postpancreatectomy hemorrhage cessation is an extremely rare phenomenon. Vascular anomalies must be considered when attempting interventional radiology treatment. CHA probably may be sacrificed with no ischemic consequences in case of severe hemorrhage in patients with CAS.
胰十二指肠切除术后出血（PPH）是胰腺手术的严重并发症。这种情况通常在胰瘘的背景下发生。在我们的报告中，我们展示了一例罕见病例，一名患有腹腔干狭窄（CAS）的患者在远端胰腺切除术后，严重的胰十二指肠切除术后肝总动脉（CHA）出血自发停止。一名64岁男性被诊断为胰尾肿瘤，接受了扩大的远端胰腺切除术。他出现了胰瘘，带着腹腔引流管出院，随后因CHA假性动脉瘤导致的严重胰十二指肠切除术后出血再次入院。由于CHA血栓形成，出血自行停止。患者未出现缺血症状。胰十二指肠切除术后严重出血自发停止是一种极其罕见的现象。在尝试介入放射学治疗时，必须考虑血管异常情况。对于患有CAS的患者，在严重出血的情况下，CHA可能可以被牺牲而不会产生缺血后果。
