Massive gastric bleeding-perforation of pancreatic pseudocyst into the stomach: A case report and review of literature

BACKGROUND Pancreatic pseudocyst may cause serious gastrointestinal complications including necrosis,infection,and perforation of the gastrointestinal tract wall,but massive gastric bleeding is very rare.CASE We report a rare case of a 49-year-old man with life-threatening gastric bleeding from a pseudoaneurysm of the splenic artery perforating the stomach induced by pancreatic pseudocyst.During hospitalization,gastroscopy revealed a bare blood vessel in an ulcer-like depression of the greater gastric curvature,and computed tomography scan confirmed a pancreatic pseudocyst invading part of the spleen and gastric wall of the greater curvature.Arteriography showed that the bare blood vessel originated from a pseudoaneurysm of the splenic artery.The bleeding was controlled by the trans-arterial embolization,the patient’s recovery was rapid and uneventful.CONCLUSION Massive gastrointestinal bleeding could be a rare complication of pancreatic pseudo aneurysm.

消化道动脉灶性出血的内镜注射套扎联合治疗

目的探讨内镜注射套扎联合治疗消化道动脉灶性出血的可行性、安全性和临床应用价值。方法对消化道Dieulafoy病、息肉切除术后和消化性溃疡的动脉灶性出血的患者,进行内镜注射套扎联合治疗,首先于出血的动脉及其周围的黏膜下层注射10%高渗钠溶液3～5mL,其后应用单发或双发套扎器,套扎出血的动脉及其周围组织,从而达到止血的目的。结果胃、十二指肠和直肠Dieulafoy病出血12例(ForrestⅠa10例、Ⅱa2例),胃、大肠息肉切除术后出血6例(ForrestⅠa6例),胃、十二指肠球部溃疡出血8例(ForrestⅠa6例、Ⅱa2例),共26例动脉灶性出血的患者,经内镜注射套扎联合治疗后均止血成功,并以瘢痕愈合而治愈,无并发症发生。结论内镜注射套扎联合治疗消化道动脉灶性出血具有明确的理论基础,操作简易,疗效确切,是一种可行的、安全的和有效的治疗方法。