Oliveira Trindade Bruna, Herrmann Fábio, Biolchi Matheus, Clayton Rone, Hamaoui Mohamad, Christ Machry Mayara, Mariano Rodrigo, Lucchese Angélica
Medical School, Federal University of Health Sciences of Porto Alegre, Porto Alegre, BRA.
Gastrointestinal Surgery, Santa Casa de Porto Alegre Hospital, Porto Alegre, BRA.
Cureus. 2024 Sep 7;16(9):e68897. doi: 10.7759/cureus.68897. eCollection 2024 Sep.
A pancreatic pseudocyst, typically resulting from acute pancreatitis, is a cystic lesion that lacks a true epithelial layer and can lead to various complications, including hemorrhage, which is most often associated with the splenic artery. Hemorrhage within a pseudocyst is a rare but severe complication, manifesting as intracystic, peritoneal, or gastrointestinal tract bleeding. We present a unique case of a 50-year-old male farmer with a history of acute pancreatitis who developed an intracystic hemorrhage due to ischemia in the splenic artery traversing a pancreatic pseudocyst. The patient was successfully treated with angiographic embolization after presenting with symptoms of gastrointestinal bleeding, hypotension, and abdominal pain. Initial management included conservative monitoring, but upon further complications, intervention became necessary. The patient's postoperative course was uneventful, and follow-up imaging confirmed the resolution of the hemorrhage and stabilization of the pseudocyst. This case underscores the importance of recognizing and promptly treating hemorrhagic pancreatic pseudocysts, particularly those involving visceral vessels. It also highlights the role of angiographic embolization as an effective treatment option. Given the rarity of such cases, our report aims to contribute to the growing body of literature and provide guidance for the management of similar cases in the future. Continued documentation and study of these cases are essential to developing standardized treatment protocols and improving patient outcomes.
胰腺假性囊肿通常由急性胰腺炎引起，是一种缺乏真正上皮层的囊性病变，可导致各种并发症，包括出血，出血最常与脾动脉相关。假性囊肿内出血是一种罕见但严重的并发症，表现为囊内、腹膜或胃肠道出血。我们报告了一例独特病例，一名50岁男性农民，有急性胰腺炎病史，因穿过胰腺假性囊肿的脾动脉缺血而发生囊内出血。该患者在出现胃肠道出血、低血压和腹痛症状后，通过血管造影栓塞术成功治疗。初始治疗包括保守监测，但出现进一步并发症后，干预变得必要。患者术后病程平稳，随访影像学检查证实出血已消退，假性囊肿已稳定。该病例强调了认识并及时治疗出血性胰腺假性囊肿的重要性，尤其是那些累及内脏血管的囊肿。它还突出了血管造影栓塞术作为一种有效治疗选择的作用。鉴于此类病例罕见，我们的报告旨在为不断增加的文献做出贡献，并为未来类似病例的管理提供指导。持续记录和研究这些病例对于制定标准化治疗方案和改善患者预后至关重要。
