Stabile B E, Wilson S E, Debas H T
Arch Surg. 1983 Jan;118(1):45-51. doi: 10.1001/archsurg.1983.01390010035009.
Exigent hemorrhage from pseudocysts and pseudoaneurysms is the most rapidly lethal complication of pancreatitis. Of eight patients with this unusual entity seen by us, all had acute gastrointestinal hemorrhage; two patients had intraperitoneal bleeding as well. Preoperative visceral arteriograms accurately defined the bleeding lesion and greatly aided in planning operative strategy in six patients. Emergency celiotomy and arterial ligation were accomplished in seven patient, and one patient underwent successful transcatheter arterial embolization. Pancreatic resection was not required in any patient for control of hemorrhage, although gastrectomy was necessary in three cases. One elderly patient died of sepsis five weeks after operation. Our mortality of 12.5% compares favorably with the 37% overall mortality from 123 cases reported in the literature.
假性囊肿和假性动脉瘤引起的急症出血是胰腺炎最迅速致命的并发症。在我们所见到的8例患有这种罕见病症的患者中，均出现急性胃肠道出血；2例患者还伴有腹腔内出血。术前内脏动脉造影准确地确定了出血病变，并极大地有助于为6例患者制定手术策略。7例患者接受了急诊剖腹术和动脉结扎，1例患者成功接受了经导管动脉栓塞术。为控制出血，所有患者均无需进行胰腺切除术，不过有3例患者需要行胃切除术。1例老年患者术后5周死于败血症。我们12.5%的死亡率与文献报道的123例患者37%的总体死亡率相比更有利。
