van Rooyen W, van Blankenstein M, Eeftinck Schattenkerk M, de Vries J E, Obertop H, Bruining H A, van Houten H
Br J Surg. 1984 Feb;71(2):137-40. doi: 10.1002/bjs.1800710220.
Recurrent upper gastrointestinal haemorrhage arising from the pancreatic duct presents diagnostic difficulties. Bleeding can be secondary to pancreatic disease (pancreatitis, pseudocysts) or vascular disorders (aneurysms of the splanchic arteries). Of the 5 cases reported here, 3 involved a ruptured aneurysm of the splenic artery and 2 chronic pancreatitis. Attacks of colicky pain in the left epigastric region associated with haematemesis and/or melaena were characteristic symptoms. Pancreatectomy controlled the bleeding in 4 and ligation of the splenic artery and the pancreatic duct in one. Fifty-five patients with similar pathology have been previously reported, suggesting that this syndrome should be borne in mind when gastrointestinal haemorrhage of obscure origin is encountered. If routine endoscopy does not reveal the site of the haemorrhage and there are no signs of cholestasis, endoscopic retrograde pancreatography (ERP) and selective coeliac arteriography should be performed to evaluate the possibility of haemorrhage from the pancreatic duct. Surgical management depends on the site of the causative lesion.
源自胰管的复发性上消化道出血存在诊断困难。出血可能继发于胰腺疾病（胰腺炎、假性囊肿）或血管疾病（内脏动脉动脉瘤）。在此报告的5例病例中，3例涉及脾动脉动脉瘤破裂，2例为慢性胰腺炎。左上腹绞痛发作伴呕血和/或黑便是其特征性症状。胰切除术控制了4例出血，1例通过结扎脾动脉和胰管控制了出血。此前已报道过55例具有类似病理的患者，这表明当遇到不明原因的胃肠道出血时应考虑到这种综合征。如果常规内镜检查未发现出血部位且无胆汁淤积迹象，应进行内镜逆行胰胆管造影（ERP）和选择性腹腔动脉造影，以评估胰管出血的可能性。手术治疗取决于致病病变的部位。
