Almaguer Joey, Murray Dylan, Motamedi Sheedeh, Murray Richard
Radiology, Texas Tech University Health Sciences Center, Amarillo, USA.
Surgery, University College Dublin, Dublin, IRL.
Cureus. 2023 Sep 11;15(9):e45039. doi: 10.7759/cureus.45039. eCollection 2023 Sep.
Gastric intramural hematoma (GIH) is a contained hemorrhage located within the layers that comprise the wall of the stomach. It is a rare condition that has a variety of etiologies. Pancreatitis-induced GIH is an even rarer phenomenon, with only a handful of documented cases in the medical literature. In the current case, a patient presented with chronic abdominal pain for the past two months, with an acute worsening of symptoms. CT imaging confirmed a large, stable GIH with concomitant pancreatitis, likely alcohol-induced. Diagnostic laparoscopy was performed in response to worsening hemodynamic status, which confirmed hemorrhagic pancreatitis as the likely cause of the GIH formation. Jackson-Pratt (JP) drains were placed, and the patient was subsequently discharged. The patient returned one month later with an acute exacerbation of pancreatitis; however, interval improvement of the GIH was observed. The patient was transferred to outpatient care for continued conservative treatment without any further return visits.
胃壁内血肿（GIH）是一种局限于构成胃壁各层内的出血。它是一种病因多样的罕见病症。胰腺炎诱发的GIH更是罕见现象，医学文献中仅有少数病例记载。在本病例中，一名患者过去两个月一直有慢性腹痛，症状近期急性加重。CT成像证实有一个较大的、稳定的GIH，同时伴有胰腺炎，可能是酒精所致。鉴于血流动力学状态恶化，进行了诊断性腹腔镜检查，证实出血性胰腺炎可能是GIH形成的原因。放置了杰克逊-普拉特（JP）引流管，随后患者出院。患者一个月后因胰腺炎急性加重再次就诊；不过，观察到GIH有阶段性改善。该患者被转为门诊治疗进行持续保守治疗，未再有复诊情况。
