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Pancreatic pseudocyst bleeding associated with massive intraperitoneal hemorrhage.

Hsin-Hui Chiu1, Chan-Ming Chen, Ko-Chin Wang

  • 1Department of Medicine, Division of Gastroenterology, Kuo General Hospital, No 22. Sec 2, Ming-Sheng Road, Tainan 703, Taiwan. shchiu@kgh.com.tw

American Journal of Surgery
|June 14, 2006
PubMed
Summary

Hemorrhagic pancreatic pseudocysts, often linked to alcohol abuse, can be fatal if untreated. This case highlights successful emergency surgery for a ruptured pseudocyst with intraperitoneal bleeding, improving patient outcomes.

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Area of Science:

  • Gastroenterology
  • Surgical Oncology

Background:

  • Pancreatic pseudocyst bleeding is a rare but serious cause of acute abdominal pain, particularly in individuals with a history of alcoholism.
  • Conservative management of hemorrhagic pancreatic pseudocysts is associated with high mortality rates.

Observation:

  • A 37-year-old male presented with acute abdominal pain and swelling, indicative of a pseudoaneurysm in the pancreatic tail.
  • Abdominal imaging revealed pancreatic calcifications, a cystic lesion with a calcified wall, and significant ascites, with contrast extravasation suggesting active hemorrhage.

Findings:

  • Surgical exploration confirmed active bleeding from a ruptured pancreatic pseudocyst in the pancreatic tail.
  • Ligation of the bleeding vessel was successfully performed during emergency laparotomy.

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Implications:

  • Hemorrhage into pancreatic pseudocysts with intraperitoneal bleeding represents a life-threatening emergency.
  • Prompt surgical intervention is crucial for managing this condition and improving patient survival rates.