胰腺炎并假性动脉瘤继发消化道大出血诊治剖析

摘要

Objective To investigate the key points of diagnosis and treatment of pancreatic pseudoneurysm compli-cated with massive gastrointestinal hemorrhage. Methods Clinical data of a pancreatitis patient complicated with pseudoan-eurgs clinically manifested by massive hemorrhage was retrospectively analyzed, and the relevant literatures were reviewed. Results The patient was admitted for abdominal pain, hematemesis and tarry stool for a week, and had a history of pancreati-tis for 5 years. The patient with the major clinical symptom of massive gastrointestinal hemorrhage was diagnosed by abdominal enhanced CT, and then checked by digital subtraction angiography ( DSA) . The patient was treated by transcatheter arterial embolism ( TAE ) . After remobilization, clinical symptom was significantly alleviated, and discharged from hospital. CT showed no bleeding foci after 11 months of follow up after discharge, no gastrointestinal hemorrhage recurred. Conclusion Pancreatic pseudoneurysm is one of the rare complications of chronic pancreatitis. CT, DSA are the main diagnosis methods, and TAE is a safe and effective method for treatment of pancreatitis with pseudoaneurysm.%目的：探讨胰腺炎并假性动脉瘤继发消化道大出血的诊治要点。方法回顾性分析以消化道大出血为主要临床表现的胰腺炎并假性动脉瘤1例的临床资料并复习相关文献。结果本例因腹痛伴呕血、排柏油便1周入院。有胰腺炎病史5年。行腹部增强CT示疑似胃十二指肠假性动脉瘤破裂,行数字减影血管造影( DSA)确诊后行经导管动脉栓塞( TAE)治疗,栓塞后未再出血,痊愈出院。随访11个月,无再发出血。结论胰腺炎并假性动脉瘤形成是胰腺炎较少见的并发症之一,诊断主要依据CT、DSA等影像学检查,TAE是治疗胰源性假性动脉瘤最安全、有效的方法。