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Acute gastrointestinal bleeding as a complication of pancreatic pseudocysts
D Henne-Bruns1, G Fröschle, H Grimm
1Department of Surgery, University of Hamburg, FRG.
Insights
This study details 6 patients with chronic pancreatitis and pancreatic pseudocysts experiencing acute bleeding. Surgical intervention for hemostasis and/or drainage successfully managed hemorrhage without mortality.
Area of Science:
- Gastroenterology and Hepatology
- Surgical Oncology
- Interventional Radiology
Background:
- Chronic pancreatitis frequently leads to pancreatic pseudocysts.
- Pancreatic pseudocysts can develop serious complications, including hemorrhage.
- Hemorrhage into pseudocysts poses a significant management challenge.
Observation:
- Six patients with chronic pancreatitis and pseudocysts presented with acute bleeding into the cyst.
- Hemorrhage originated from the splenic artery/vein, renal artery, aorta, or splenic parenchyma.
- Four patients experienced acute hemorrhage during hospitalization.
Findings:
- All patients underwent surgical procedures for hemostasis and/or cyst drainage/resection.
- Three patients required additional splenectomy.
- No postoperative mortality was observed.
- CT-scan and angiography aided in localizing bleeding sources in two cases.
Implications:
- Surgical management of bleeding pancreatic pseudocysts is effective and associated with low mortality.
- Prompt diagnosis and intervention are crucial for managing this complication.
- Understanding the vascular origins of bleeding is vital for surgical planning.
Abstract:
We report on 6 patients with chronic pancreatitis and pancreatic pseudocysts, operated on for acute bleeding into the cyst. The splenic artery and vein, the renal artery, the aorta and the splenic parenchyma were identified as bleeding sites. In 4 patients the acute hemorrhage occurred during hospitalization. In all patients the operative procedure included hemostasis and/or drainage/resection of the cyst. In 3 cases an additional splenectomy was performed. None of the patients died postoperatively. In 5 patients the pancreatitis was induced by alcohol abuse. In all patients the pseudocysts were diagnosed prior to the acute hemorrhage. CT-scan and angiography were able to localize the origin of the bleeding in 2 cases.