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Hemorrhage as a complication of chronic pancreatitis


Authors: Kancnýř J.;  Kovala P.;  Kremer M.
Authors‘ workplace: Interna, Městská nemocnice Ostrava, p.  o.
Published in: Gastroent Hepatol 2018; 72(6): 527-530
Category:
doi: https://doi.org/10.14735/amgh2018527

Overview

Hemorrhage due to chronic pancreatitis is an unusual complication, which can be life threatening, depending on its localization and intensity. Early diagnosis and hemorrhage localization are very important. Choice of the appropriate intervention depends on the actual hemodynamic condition and technical feasibility. This case report describes a patient with a long term history of chronic pancreatitis, complicated by a pancreatic head pseudocyst. The patient came to the hospital because of acute abdominal pain. During the examination, enlargement of the pseudocyst was detected, which was accompanied by oppression of the extrahepatic biliary duct. An intrapseudocyst hemorrhage was suspected. After CT revealed leakage of the contrast agent into the pseudocyst lumen, angiography was employed, which demonstrated coiling of a broken artery. After this, endoscopic retrograde cholangiopancreatography with biliary stent insertion to the d. choledochus was performed. During application of the contrast agent to the biliary ducts, the pseudocysts lumen was filled with the contrast agent, making transpapillary drainage possible using a mono pigtail. Complete regression of the pancreatic pseudocyst and spontaneous elimination of the mono pigtail were observed during a subsequent examination.

Keywords:

chronic pancreatitis – pancreatic pseudocyst – haemorrhage – angiography

Submitted: 23. 3. 2018

Accepted: 3. 7. 2018

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for bio­­­­medical papers.


Sources

1. Bouas­sida M, Benali M, Char­rada H et al. Gastrointestinal bleed­­ing due to an erosion of the superior mesenteric artery: an exceptional fatal complication of pancreatic pseudocyst. Pan Afr Med J 2012; 12: 62.

2. Houska A, Závada F, Lacman J et al. Neobvyklá komplikace chronické pankreatitidy. Gastroent Hepatol 2011; 65(3): 154–156.

3. Garcea G, Krebs M, Lloyd T et al. Haemor­rhage from pancreatic pseudocysts present­­ing as upper gastrointestinal haemor­rhage. Asian J Surg 2004; 27(2): 137–140. doi: 10.1016/S1015-9584(09)60328-6.

4. Am­mori BJ, Madan M, Alexander DJ. Haemor­rhagic complications of pancreatitis: presentation, dia­gnosis and management. Ann R Coll Surg Engl 1998; 80(5): 316–325.

5. Novacic K, Vidjak V, Suknaic S et al. Embolization of a large pancreatic pseudoaneurysm converted from pseudocyst (hemor­rhagic pseudocyst). JOP 2008; 9(3): 317–321.

6. Novotný I, Boudný J, Kala Z. Hemosuccus pancreaticus jako komplikace akutní exacerbace chronické pankreatitidy. Česk Slov Gastroenterol Hepatol 2004; 58(1): 16–20.

7. Zarin M, Ali S, Majid A et al. Gastroduodenal artery aneurysm – post traumatic pancreatic pseudocyst drainage – an interest­­ing case. Int J Surg Case Rep 2018; 42: 82–84. doi: 10.1016/j.ijscr.2017.11.049.

8. Yu P, Gong J. Hemosuccus pancreaticus: A mini-review. Ann Med Surg 2018; 28: 45–48. doi: 10.1016/j.amsu.2018.03.002.

9. Peynircioğlu B, Karaosmanoğlu AD, Idilman IS et al. Intrapancreatic pseudoaneurysm caus­­ing mas­sive gastrointestinal hemor­rhage and chronic pancreatitis. Turk J Gastroenterol 2015; 26(3): 270–273. doi: 10.5152/tjg.2015.6548.

10. Rana SS, Singhal M, Sharma A et al. Succes­s­­-ful hemostasis of arterial bleed­­ing in chronic pseudocyst by direct endoscopic injection of N-butyl-2-cyanoacrylate in the pseudoaneurysm. Gastrointest Endosc 2015; 81(4): 1046–1047. doi: 10.1016/j.gie.2014.09.057.

11. Fejfar T, Vaňásek T, Brůha R et al. Léčba krvácení v důsledku portální hypertenze při jaterní cirhóze – aktualizace doporučených postupů ČHS ČLS JEP. Gastroent Hepatol 2017; 71(2): 105–116. doi:10.14735/amgh2017105.

12. Szpakowicz J, Szpakowitz P, Urbanik A et al. Splenic artery pseudoaneurysm rupture into a pancreatic pseudocyst with its subsequent perforation as the cause of a mas­sive intra-abdominal bleeding – case report. Pol Przegl Chir 2016; 88(6): 350–355. doi: 10.1515/pjs-2016-0075.

Labels
Paediatric gastroenterology Gastroenterology and hepatology Surgery

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Gastroenterology and Hepatology

Issue 6

2018 Issue 6

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