[Diagnosis, therapy and sequelae of upper gastrointestinal haemorrhage in acute pancreatis]

Gastrointestinal bleeding complicating pancreatitis is a grave development which carries a high mortality rate. Ten out of 450 patients treated by us for pancreatitis developed gastrointestinal haemorrhage; 7 of these patients died, 6 of whom had a haemorrhagic necrotic, and one a so-called oedematous form of pancreatitis as diagnosed at autopsy. Nine operations were performed, most of them being only drainage procedures. Persistent shock or recurrence of severe symptoms with constant chemical pathological changes in the course of acute pancreatitis call for the rapid initiation of an aggressive approach towards diagnosis (endoscopy, angiography) and therapy, with radical surgical procedures, as indicated, aimed at rectifying the extensive pathology. We believe that these are the only possible means of achieving a reduction in the extremely high mortality rate in these cases and of avoiding late complications such as pseudocysts with the inherent danger of bleeding, abscesses and portal hypertension.