Reduced mortality from bleeding pseudocysts and pseudoaneurysms caused by pancreatitis
B. E. Stabile, S. E. Wilson and H. T. Debas
Exigent hemorrhage from pseudocysts and pseudoaneurysms is the most rapidly
lethal complication of pancreatitis. Of eight patients with this unusual
entity seen by us, all had acute gastrointestinal hemorrhage; two patients
had intraperitoneal bleeding as well. Preoperative visceral arteriograms
accurately defined the bleeding lesion and greatly aided in planning
operative strategy in six patients. Emergency celiotomy and arterial
ligation were accomplished in seven patient, and one patient underwent
successful transcatheter arterial embolization. Pancreatic resection was
not required in any patient for control of hemorrhage, although gastrectomy
was necessary in three cases. One elderly patient died of sepsis five weeks
after operation. Our mortality of 12.5% compares favorably with the 37%
overall mortality from 123 cases reported in the literature.
