Wada Soichiro, Matsumoto Sasagu, Sai Shuji, Ambo Yoshiyasu, Sakurai Yasuo
Department of Pediatrics, Teine Keijinkai Hospital, Sapporo, JPN.
Department of Surgery, Teine Keijinkai Hospital, Sapporo, JPN.
Cureus. 2023 Jan 1;15(1):e33228. doi: 10.7759/cureus.33228. eCollection 2023 Jan.
Vascular complications, such as pseudoaneurysms and thrombosis, are uncommon in pediatric acute pancreatitis (AP); hence, treatment experience remains limited. Here, we report a case of adolescent AP complicated with pseudoaneurysms and venous thrombosis simultaneously. Even after multiple endovascular embolizations for pseudoaneurysms, the patient experienced hemorrhagic shock resulting from pseudoaneurysm rupture after taking anticoagulants for thrombus. Inevitably, a total pancreatectomy was performed to prevent bleeding and control local complications. In AP, even among the pediatric population, a therapeutic dilemma between bleeding prevention and anticoagulation for thrombosis may occur. Despite the lack of experience with AP and its complications, a total pancreatectomy may become an alternative therapy for refractory AP or its complications.
血管并发症，如假性动脉瘤和血栓形成，在小儿急性胰腺炎（AP）中并不常见；因此，治疗经验仍然有限。在此，我们报告一例青少年AP同时并发假性动脉瘤和静脉血栓形成的病例。即使对假性动脉瘤进行了多次血管内栓塞治疗，患者在服用抗凝剂治疗血栓后仍因假性动脉瘤破裂而发生失血性休克。不可避免地，为防止出血和控制局部并发症而进行了全胰切除术。在AP中，即使在儿童群体中，也可能会在预防出血和抗凝治疗血栓之间出现治疗困境。尽管缺乏AP及其并发症的治疗经验，但全胰切除术可能成为难治性AP或其并发症的一种替代治疗方法。
