Internal bleeding as a consequence of complicated forms of chronic pancreatitis
DOI:
https://doi.org/10.11603/2414-4533.2023.3.14154Keywords:
chronic pancreatitis, pancreatic fistula, pancreatic bleedingAbstract
The aim of the work: to analyze and demonstrate our experience of treatment of complicated forms of CP, patients with internal bleeding as a complication of the severe complicated CP.
Materials and Methods. During the period 2016–2022, we diagnosed and treated 15 patients with bleeding, which accounted for 11 % of all 139 operated patients with complicated CP. Among all patients, there were 9 (60 %) women and 6 (40 %) men with a mean age of 54 years (ranged 34–70 years).
Results and Discussion. In 13 (87 %) patients, were performed immediate surgery, and the remaining 2 (13 %) underwent angiographic embolization, one of which was ineffective due to recurrence. In 2 (13 %) patients, bleeding were from the area of the head of the pancreas, in 3 (20 %) a virsungo-venous fistula were diagnosed, and in 5 (33%) a pseudoaneurysm of the splenic artery with communication with the Wirsung’s duct, 4 (27 %) patients were diagnosed with a pancreatic cyst with bleeding into the cavity communicating with the Wirsung’s duct, pseudoaneurysm of the pancreaticoduodenal artery was diagnosed in 1 (7 %).
Bleeding in CP is not common, but this complication possible in patients with CP and associated gastrointestinal bleeding. In the absence of indications for surgery related to pancreatitis, angiographic embolization may be the method of choice. If there are indications for surgery related to pancreatitis, angiographic embolization may allow for a planned surgical procedure based on structural changes in the pancreas to correct complications. If embolization fails, resection of the pancreas is usually required, often on an emergency basis.
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