Major arterial hemorrhage: a complication of pancreatic pseudocysts and chronic pancreatitis
J. C. Stanley, C. F. Frey, T. A. Miller, S. M. Lindenauer and C. G. Child 3rd
Twelve patients (11 men, one woman), aged 18 to 68 years, had major
arterial hemorrhage as a direct complication of pancreatic pseudocysts and
chronic pancreatitis. Chronic alcoholism (11 patients) and blunt abdominal
trauma (one patient) were the basis for pancreatic disease. Spontaneous
hemorrhage occurred in eight patients. Bleeding occurred into the
gastrointestinal tract (eight patients), into the peritoneal cavity (four
patients), and was intracystic (one patient). Splenic, pancreaticoduodenal,
gastroduodenal, and gastroepiploic arteries were sources of hemorrhage.
Operative procedures included local control of bleeding (six patients),
distal pancreatectomy (three patients), and pancreaticoduodenectomy (one
patient). Four patients died of hemorrhagic complications of pancreatic
disease, including one not subjected to operation. Extirpation of diseased
pancreatic tissue may lessen the morbidity and mortality attributed to this
complication of pancreatitis.
