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.
References
Chiang, K.C., Chen, T.H., & Hsu, J.T. (2014). Management of chronic pancreatitis complicated with a bleeding pseudoaneurysm. World J. Gastroenterol., 20 (43), 16132-16137. DOI – 10.3748/wjg.v20.i43.16132. PMID – 25473165; PMCID – PMC4239499. DOI: https://doi.org/10.3748/wjg.v20.i43.16132
Brock, C., Nielsen, L.M., Lelic, D. & Drewes, A.M. (2013). Pathophysiology of chronic pancreatitis. World J. Gastroenterol., 19 (42), 7231-7240. DOI – 10.3748/wjg.v19.i42.7231. PMID – 24259953; PMCID – PMC3831204.
Budipramana, V.S., Witarto, A.P., Witarto, B.S., Pramudito, S.L., Ratri, L.C., Wairooy, N.A.P & Er Putra, A.J. (2022). Risk factors for exocrine pancreatic insufficiency after pancreatic surgery – a systematic review and meta-analysis. Can. J. Surg., 65 (6), E770-E781. DOI – 10.1503/cjs.010621. PMID – 36384688; PMCID – PMC9671296. DOI: https://doi.org/10.1503/cjs.010621
Dugic, A., Hagström, H., Dahlman, I., Rutkowski, W., Daou, D., Kulinski, P., Löhr, J.M., & Vujasinovic, M. (2023). Post-pancreatitis diabetes mellitus is common in chronic pancreatitis and is associated with adverse outcomes. United European Gastroenterol J., 11 (1), 79-91. DOI – 10.1002/ueg2.12344. Epub 2022 Dec 1. PMID – 36454055; PMCID – PMC9892477. DOI: https://doi.org/10.1002/ueg2.12344
Kopchak, V.M., Pylypchuk, V.I., Andronik, S.V., Pererva, L.O. (2014). Suchasni pohliady na problem khirurhichnoho likuvannia khronichnoho pankreatytu [Modern views on the problem of surgical treatment of chronic pancreatitis]. Clinichna khirurhiia – Clinical Surgery, (9), 28-30 [in Ukrainian].
Vujasinovic, M., Dugic, A., Maisonneuve, P., Aljic, A., Berggren, R., Panic, N., ... & Löhr, J. M. (2020). Risk of developing pancreatic cancer in patients with chronic pancreatitis. Journal of Clinical Medicine, 9 (11), 3720. DOI – 10.3390/jcm9113720. PMID – 33228173; PMCID – PMC7699479. DOI: https://doi.org/10.3390/jcm9113720
Alhobayb, T., Peravali, R., & Ashkar, M. (2021). The Relationship between Acute and Chronic Pancreatitis with Pancreatic Adenocarcinoma – Review. Diseases., 9(4), 93. DOI – 10.3390/diseases9040093. PMID – 34940031; PMCID – PMC8700754. DOI: https://doi.org/10.3390/diseases9040093
Raksha, N.G., Halenova, T.I., Vovk, T.B., Sukhodolia, S.A., Beregova, T.V., & Ostapchenko, L.I. (2019). Proteolitic imbalance as a key factor of the development of chronic pancreatitis with and without type 1 diabetes mellitus. Visnik problem biologii i medicine – Herald of Probl. of Biol. and Med. 3 (152), 186-191. DOI – 10, 2077-4214. DOI: https://doi.org/10.29254/2077-4214-2019-3-152-186-191
Raksha, N., Halenova, T., Vovk, T., Savchuk, O., Berehovyi, S., Beregova, T., & Ostapchenko, L. (2020). Disturbances of extracellular protein metabolism in ceruleininduced pancreatitis. Current Issues in Pharmacy and Medical Sciences, 33 (3), 121-4. DOI: https://doi.org/10.2478/cipms-2020-0022
Synelnyk, T.B., Kravchenko, O.O., Kostiuk, O.S., Sukhodolia, S.A., & Ostapchenko, L.I. (2022). Distribution of serine proteases in blood plasma and pancreas in chronic pancreatitis and oncopathology. Fiziologichnyi Zhurnalt., 68(6), 31-43. DOI: https://doi.org/10.15407/fz68.06.031
Sukhodolia, A.I., Sukhodolia, S.A., Mosiychuk, V.P., & Makohonskyi, M.V. (2019). Chronic pancreatitis and diabetes mellitus – predictors of development of pancreatic cancer. Klinicheskaia Khirurgiia – Clin. Surg., 86 (4), 67-71. https –//doi.org/10.26779/2522-1396.2019.04.67 DOI: https://doi.org/10.26779/2522-1396.2019.04.67
Dronov, O.I., Kryuchyna, Ye.A., Khomenko, D.I., Skomarovsky, O.A., Gorlach, A.I., Zemskov S.V., et al (2013). Chronic pancreatitis as a risk factor of pancreatic cancer development. Khirurhiia Ukrainy – Surgery of Ukraine, 47 (3), 112-6 [in Ukrainian].
Vujasinovic, M., Dugic, A., Nouri, A., Brismar, T. B., Baldaque-Silva, F., Asplund, E., ... & Löhr, J. M. (2021). Vascular complications in patients with chronic pancreatitis. Journal of Clinical Medicine, 10 (16), 3720. DOI: https://doi.org/10.3390/jcm10163720
Brock, C., Nielsen, L.M., Lelic, D., & Drewes. A.M. (2013). Pathophysiology of chronic pancreatitis. World J. Gastroenterol., 19 (42), 7231-7240. DOI – 10.3748/wjg.v19.i42.7231. PMID – 24259953; PMCID – PMC3831204. DOI: https://doi.org/10.3748/wjg.v19.i42.7231
Gambiez, L.P., Ernst, O.J., Merlier, O.A., Porte, H.L., Chambon, J.P., & Quandalle, P.A. (1997). Arterial embolization for bleeding pseudocysts complicating chronic pancreatitis. Arch. Surg., 132 (9), 1016-1021. DOI – 10.1001/archsurg.1997.01430330082014. PMID – 9301616. DOI: https://doi.org/10.1001/archsurg.1997.01430330082014
Ugonabo, O.S., Elghezewi, A., Ezeh, E., Reynolds, J., Sherif, A., & Frandah, W. (2022). The Tale of a Bleeding Tree – A Rare Case of Peripancreatic Variceal Hemorrhage Causing Hemosuccus Pancreaticus. Cureus., 14 (7), e27106. DOI – 10.7759/cureus.27106. PMID – 36004022; PMCID – PMC9392470. DOI: https://doi.org/10.7759/cureus.27106
Dhali, A., Ray, S., Sarkar, A., Khamrui, S., Das, S., Mandal, T.S., Biswas D.N., & Dhali, G.K. (2022). Peripancreatic arterial pseudoaneurysm in the background of chronic pancreatitis – clinical profile, management, and outcome. Updates Surg., 74(4), 1367-1373. DOI – 10.1007/s13304-021-01208-y. Epub 2021 Nov 23. PMID – 34816352. DOI: https://doi.org/10.1007/s13304-021-01208-y
LOWER, W. E., & FARRELL, J. I. (1931). Aneurysm of the splenic artery: report of a case and review of the literature. Archives of Surgery, 23(2), 182-190. DOI: https://doi.org/10.1001/archsurg.1931.01160080010002
Sandblom, P. (1970). Gastrointestinal hemorrhage through the pancreatic duct. Annals of surgery, 171(1), 61. DOI: https://doi.org/10.1097/00000658-197001000-00009
Udd, M., Leppäniemi, A.K., Bidel, S., Keto, P., Roth, W.D., & Haapiainen, R.K. (2007). Treatment of bleeding pseudoaneurysms in patients with chronic pancreatitis. World J Surg., 31(3), 504-10. DOI – 10.1007/s00268-006-0209-z. PMID – 17322972. DOI: https://doi.org/10.1007/s00268-006-0209-z
Usenko, О.Y., Sukhodolya, А.І., Sukhodolya, S.А., LobodaІ, V., Моnastyrskyi, V.М., & Prosvitlyuk, P.V. (2017). Pancreatic fistulas as a complication of chronic pancreatitis. Diagnosis and treatment. Klinicheskaia Khirurgiia – Clin. Surg., (9) –10-3. https –//doi.org/10.26779/2522-1396.2017.09.10 DOI: https://doi.org/10.26779/2522-1396.2017.09.10
Kempeneers, M.A., Issa, Y., Ali, U.A., Baron, R.D., Besselink, M.G., Büchler, M., ... & Boermeester, M. A. (2020). Working group for the International (IAP–APA–JPS–EPC) Consensus Guidelines for Chronic Pancreatitis. International consensus guidelines for surgery and the timing of intervention in chronic pancreatitis. Pancreatology, 20 (2), 149-157. DOI – 10.1016/j.pan.2019.12.005. Epub 2019 Dec 17. PMID – 31870802. DOI: https://doi.org/10.1016/j.pan.2019.12.005
Synelnyk T.B., Kravchenko O.O., Kostiuk O.S., Sukhodolia S.A., & Ostapchenko L.I. (2022). The trigger components of the proteolytic system and their modulators contents under pancreatic pathologies development. Fiziologichnyi Zhurnal., 68 (5), 33-44. DOI: https://doi.org/10.15407/fz68.05.033
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