Sanchez Cruz Camila, Abera Woldehana Nathnael, Ponce-Lujan Lorraine, Shettywarangale Pranay, Shekhawat Pallavi, da Silva Naofal, Reyes Gochi Kevin A, Reyes Gochi Mario D
General Practice, Universidad Nacional Autonoma de Mexico, Mexico City, MEX.
Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
Cureus. 2024 Jul 21;16(7):e65064. doi: 10.7759/cureus.65064. eCollection 2024 Jul.
Hemorrhagic pancreatitis, a severe complication of acute and chronic pancreatitis, involves bleeding due to vascular disruptions. This condition presents significant clinical challenges and is associated with high morbidity and mortality. The bleeding can result from arterial or venous complications, often exacerbated by inflammatory and enzymatic damage to blood vessels within the pancreas. Patients with hemorrhagic pancreatitis may experience symptoms such as abdominal pain, nausea, vomiting, and gastrointestinal bleeding. Diagnostic imaging, including CT and MRI, is crucial in identifying the source of bleeding and guiding treatment decisions. Management strategies have evolved over the past two decades, shifting from purely surgical approaches to including interventional radiology techniques. Surgical intervention is often reserved for hemodynamically unstable patients or those with large pseudoaneurysms, offering definitive treatment but carrying higher risks of complications. Endovascular techniques, such as transcatheter embolization, provide a less invasive alternative with high success rates and shorter recovery times, though rebleeding may occur. Treatment choice depends on various factors, including the patient's stability, the size and location of the bleeding, and the availability of specialized expertise. Overall, the management of hemorrhagic pancreatitis requires a multidisciplinary approach, combining surgical and radiological techniques to optimize patient outcomes and reduce the risk of mortality. Long-term follow-up is essential to monitor for recurrent disease and manage the metabolic consequences of pancreatic insufficiency.
出血性胰腺炎是急慢性胰腺炎的一种严重并发症，因血管破裂而导致出血。这种情况带来了重大的临床挑战，且与高发病率和高死亡率相关。出血可能由动脉或静脉并发症引起，胰腺内血管的炎症和酶性损伤常常会加剧这种情况。出血性胰腺炎患者可能会出现腹痛、恶心、呕吐和胃肠道出血等症状。包括CT和MRI在内的诊断性影像学检查对于确定出血源和指导治疗决策至关重要。在过去二十年中，管理策略不断演变，从单纯的手术方法转变为包括介入放射学技术。手术干预通常适用于血流动力学不稳定的患者或有大型假性动脉瘤的患者，虽然能提供确定性治疗，但并发症风险更高。血管内技术，如经导管栓塞术，提供了一种侵入性较小的替代方法，成功率高且恢复时间短，不过可能会再次出血。治疗选择取决于多种因素，包括患者的稳定性、出血的大小和位置以及专业技术的可及性。总体而言，出血性胰腺炎的管理需要多学科方法，结合手术和放射学技术以优化患者预后并降低死亡风险。长期随访对于监测疾病复发和管理胰腺功能不全的代谢后果至关重要。
