Hämorrhagische Pseudocysten und Pseudoaneurysmen bei Pankreatitis Diagnostik und Therapie

Abstract

Acute hemorrhage from pseudocysts and pseudoaneurysms is a threatening complication of chronic pancreatitis. Whilst surgical intervention still has high perioperative mortality (16.8%), transcatheter arterial embolization is becoming more frequently used for suitable cases and appears to have lower mortality (6.1%). We report on six patients treated in our unit. Four of them underwent primary surgical treatment, the other two were treated by embolisation. One of the latter patients subsequently required laparotomy for further treatment. All six patients survived. Comparing the literature covering the periods between 1951 and 1981 and between 1982 and 1996, transcatheter embolisation seems to be valuable in controlling this type of bleeding, thereby reducing mortality.

Case of hemorrhagic pancreatic pseudocyst in which ultrasound imaging was useful

“…[1][2][3][4][5][6][7][8][9] Currently, bleeding pancreatic pseudocysts are usually treated by TAE using steel coils, which produces more favorable therapeutic results than surgery. 2,4,6,10,18,19 A bleeding pancreatic pseudocyst was diagnosed early in the present case. Because our knowledge of this condition was limited, however, we managed the patient by monitoring alone.The patient eventually suffered hypovolemic shock caused by rupture of the pseudocyst into the duodenum.…”

“…Because it is a dangerous complication, however, its diagnosis is clinically important. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] We describe a case of a pancreatic pseudocyst that ruptured into the duodenum, causing hypovolemic shock. Ultrasound imaging proved useful for treating this case.…”