Haemorrhagic complications of pancreatitis: presentation, diagnosis and management.

Abstract:

:Massive haemorrhage is an uncommon complication in pancreatitis. Most affected patients suffer from chronic disease with associated pseudocyst. We present five patients (four male) with a mean age of 41 years (range 34-48 years). All patients had alcohol-induced pancreatitis complicated either by haematemesis (3), intraperitoneal haemorrhage (1) or both haematemesis and intraperitoneal haemorrhage (1). Source of bleeding was pseudocyst wall (2), splenic artery pseudoaneurysm (2) and splenic artery rupture (1). Distal pancreatectomy and splenectomy was performed in two patients, intracystic ligation and drainage in two, and packing with subsequent external drainage in one. Rebleeding occurred in two patients and required subsequent distal pancreatectomy and splenectomy in one; the other patient died of splenic rupture. No rebleeding and no mortality occurred after resection. Primary pancreatic resection is recommended whenever possible. Other management options include embolisation and ligation.

journal_name

Ann R Coll Surg Engl

authors

Ammori BJ,Madan M,Alexander DJ

subject

Has Abstract

pub_date

1998-09-01 00:00:00

pages

316-25

issue

5

eissn

0035-8843

issn

1478-7083

journal_volume

80

pub_type

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