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A Journal on Surgery

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Chirurgia 1999 August;12(4):315-8

language: Italian

Gastrointestinal bleeding due to pancreatic pseudocyst

Rispo A., Scotto Di Carlo E., Giuliani A., Rambaldi P. F., Mansi N., Selvaggi F.


A 55-year-old male with a history of chronic pancreatitis, upper epigastric pain and upper gastrointestinal bleeding is presented. Routine investigations did not reveal the source of bleeding. Emergency laparotomy was necessary. A haemorrhagic pancreatic pseudocyst with a duodeno-jejunal fistula was found. The patient was treated with duodencephalopancreatectomy; 48 hours after operation the patient died for cardiorespiratory failure. In patients with chronic pancreatitis and upper gastrointestinal bleeding of obscure origin a pancreatic source of bleeding should be suspected. This condition is associated with a high rate of mortality. Endoscopy, angiography, 99mTc-pertechnate-labelled erythrocyte scan are useful to find the source of bleeding; when this is not possible, an emergency operation is necessary. Pancreatic resection provides a definitive hemostasis instead of other surgical or conservative procedures.

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