严重的急性胰腺炎由多次腹内出血复杂化
Cong-Yu Wang1, Yin Gu2, Rui-Peng Yan2
1Department of Graduate, Tianjin Medical University, Tianjin, China.
Case reports in gastroenterology
|February 20, 2025
概括
严重的急性胰腺炎 (SAP) 可以导致罕见的,危及生命的腹内出血. 这一案例突显了SAP中多重动脉出血的成功管理,使用数字减去血管学 (DSA) 和栓塞.
科学领域:
- 胃肠病学 胃肠病学
- 血管外科 血管外科
- 干预性放射学 干预性放射学
背景情况:
- 腹内出血是严重急性胰腺炎 (SAP) 的罕见但严重并发症.
- 血管壁侵蚀和伪动脉瘤破裂是SAP出血的主要原因.
- 在SAP中,多次连续的动脉出血非常罕见.
研究的目的:
- 呈现一种严重的急性胰腺炎病例,并由大规模的,反复的腹内出血复杂化.
- 为了说明数字减去血管学 (DSA) 和栓塞在管理此类关键出血事件中的诊断和治疗作用.
- 突出涉及干预性放射学和外科管理的多学科方法的成功结果.
主要方法:
- 一个31岁的男性患者的病例报告,患有严重的急性胰腺炎.
- 管理涉及密集护理,重复的数字减去血管造影 (DSA) 进行出血局部化和栓塞.
- 为了基础的SAP管理,进行了分阶段的胰腺瘤切除术和皮肤间排水.
主要成果:
- 患者在60天内经历了三次主要的腹腔内出血,最大血损失为1500毫升.
- DSA成功地确定了出血源,并且在每个情况下都进行了栓塞.
- 患者在6个月的治疗后完全康复,并没有再次出血,感染得到控制.
结论:
- 腹内出血是SAP的关键并发症,需要及时诊断和干预.
- 数字减去血管造影 (DSA) 对于精确定位和立即栓塞出血的伪动脉瘤是无价的.
- 干预性放射学和手术管理的结合可以在复杂的SAP相关出血中取得成功.
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