Nishida K, Terai Y, Nojiri I, Kato M, Higashijima M, Takagi K, Adashi R
Department of Internal Medicine, Takagi Hospital.
Nihon Ronen Igakkai Zasshi. 1993 Aug;30(8):714-9. doi: 10.3143/geriatrics.30.714.
The case is a 83-year-old woman who came to our hospital with melena and epigastralgia as chief complaints, presenting pre-shock state with high serum amylase value. ERP revealed diffuse dilatation of pancreatic duct and cyst of the accessory pancreatic duct. Endoscopy showed hemorrhage of the accessory papilla. A diagnosis of chronic pancreatitis and hemosuccus pancreaticus was made. Because of the patient's advanced age, conservative treatment (total parenchymal nutrition, transfusion, hemostatics, etc.) were prescribed. The patient succumbed due to heart failure 15 months later. This case of gastrointestinal bleeding from a pancreatic pseudocyst due to neighboring arterial rupture is discussed with reference to some related literature.
该病例为一名83岁女性，以黑便和上腹部疼痛为主诉前来我院就诊，呈现休克前期状态，血清淀粉酶值升高。内镜逆行胰胆管造影（ERP）显示胰管弥漫性扩张及副胰管囊肿。内镜检查显示副乳头出血。诊断为慢性胰腺炎和胰管出血。由于患者年事已高，给予保守治疗（全胃肠外营养、输血、止血药等）。15个月后，患者因心力衰竭死亡。本文结合一些相关文献，对这例因邻近动脉破裂导致胰腺假性囊肿引起的胃肠道出血病例进行了讨论。
