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Annals of The Royal College of Surgeons of England logoLink to Annals of The Royal College of Surgeons of England
. 1998 Sep;80(5):316–325.

Haemorrhagic complications of pancreatitis: presentation, diagnosis and management.

B J Ammori 1, M Madan 1, D J Alexander 1
PMCID: PMC2503105  PMID: 9849330

Abstract

Massive haemorrhage is an uncommon complication in pancreatitis. Most affected patients suffer from chronic disease with associated pseudocyst. We present five patients (four male) with a mean age of 41 years (range 34-48 years). All patients had alcohol-induced pancreatitis complicated either by haematemesis (3), intraperitoneal haemorrhage (1) or both haematemesis and intraperitoneal haemorrhage (1). Source of bleeding was pseudocyst wall (2), splenic artery pseudoaneurysm (2) and splenic artery rupture (1). Distal pancreatectomy and splenectomy was performed in two patients, intracystic ligation and drainage in two, and packing with subsequent external drainage in one. Rebleeding occurred in two patients and required subsequent distal pancreatectomy and splenectomy in one; the other patient died of splenic rupture. No rebleeding and no mortality occurred after resection. Primary pancreatic resection is recommended whenever possible. Other management options include embolisation and ligation.

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Selected References

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  1. ARNER O., FERNSTROM I. Obstruction of the splenic vein. A splenoportographic study of the clinical features of "thrombosis of the splenic vein" with notes on its treatment. Acta Chir Scand. 1961 Aug;122:66–74. [PubMed] [Google Scholar]
  2. Agarwal P., Phadke R. V., Baijal S. S., Yachha S. K., Sharma B. C., Poddar U. Calcific pancreatitis-induced gastroduodenal artery pseudoaneurysm: non-surgical management. Pediatr Radiol. 1994;24(7):539–540. doi: 10.1007/BF02015026. [DOI] [PubMed] [Google Scholar]
  3. Alwmark A., Gullstrand P., Ihse I., Joelsson B., Owman T. Regional, portal hypertension in chronic pancreatitis. Acta Chir Scand. 1981;147(2):155–157. [PubMed] [Google Scholar]
  4. Arnaud J. P., Bergamaschi R., Serra-Maudet V., Casa C. Pancreatoduodenectomy for hemosuccus pancreaticus in silent chronic pancreatitis. Arch Surg. 1994 Mar;129(3):333–334. doi: 10.1001/archsurg.1994.01420270111023. [DOI] [PubMed] [Google Scholar]
  5. Baca I., Klempa I., Götzen V. Laparoskopische Pankreatocystojejunostomie ohne Entero-Entero-Anastomose. Chirurg. 1994 Apr;65(4):378–381. [PubMed] [Google Scholar]
  6. Belli G., Romano G., D'Alessandro V., Santangelo M. L. Severe hemorrhage associated with pancreatic pseudocysts: report of two cases. Int J Pancreatol. 1989 May;4(4):455–460. doi: 10.1007/BF02938480. [DOI] [PubMed] [Google Scholar]
  7. Bender J. S., Bouwman D. L., Levison M. A., Weaver D. W. Pseudocysts and pseudoaneurysms: surgical strategy. Pancreas. 1995 Mar;10(2):143–147. doi: 10.1097/00006676-199503000-00006. [DOI] [PubMed] [Google Scholar]
  8. Bender J. S., Levison M. A. Massive hemorrhage associated with pancreatic pseudocyst: successful treatment by pancreaticoduodenectomy. Am Surg. 1991 Oct;57(10):653–655. [PubMed] [Google Scholar]
  9. Borlaza G. S., Kuhns L. R., Seigel R., Pozderac R., Eckhauser F. Computed tomographic and angiographic demonstration of gastroduodenal artery pseudoaneurysm in a pancreatic pseudocyst. J Comput Assist Tomogr. 1979 Oct;3(5):612–614. doi: 10.1097/00004728-197910000-00007. [DOI] [PubMed] [Google Scholar]
  10. Boudghène F., L'Herminé C., Bigot J. M. Arterial complications of pancreatitis: diagnostic and therapeutic aspects in 104 cases. J Vasc Interv Radiol. 1993 Jul-Aug;4(4):551–558. doi: 10.1016/s1051-0443(93)71920-x. [DOI] [PubMed] [Google Scholar]
  11. Bradley E. L., 3rd The natural history of splenic vein thrombosis due to chronic pancreatitis: indications for surgery. Int J Pancreatol. 1987 Apr;2(2):87–92. doi: 10.1007/BF03015001. [DOI] [PubMed] [Google Scholar]
  12. Brant C. Q., Morais M., Rohr M. R., Siqueira E. S., Chebli J. M., Castro R. R., della Libera E., Jr, Ferrari A. P., Jr Terapêutica endoscópica do pseudocisto de pâncreas. Arq Gastroenterol. 1995 Jul-Sep;32(3):110–115. [PubMed] [Google Scholar]
  13. Bresler L., Boissel P., Grosdidier J. Major hemorrhage from pseudocysts and pseudoaneurysms caused by chronic pancreatitis: surgical therapy. World J Surg. 1991 Sep-Oct;15(5):649–653. doi: 10.1007/BF01789217. [DOI] [PubMed] [Google Scholar]
  14. Bretagne J. F., Heresbach D., Darnault P., Raoul J. L., Gosselin M., Carsin M., Gastard J. Pseudoaneurysms and bleeding pseudocysts in chronic pancreatitis: radiological findings and contribution to diagnosis in 8 cases. Gastrointest Radiol. 1990 Winter;15(1):9–16. doi: 10.1007/BF01888725. [DOI] [PubMed] [Google Scholar]
  15. Brintnall B. B., Laidlaw W. W., Papp J. P. Hemobilia: pancreatic pseudocyst hemorrhage demonstrated by endoscopy and arteriography. Am J Dig Dis. 1974 Feb;19(2):186–188. doi: 10.1007/BF01072632. [DOI] [PubMed] [Google Scholar]
  16. Bucknam C. A. Arterial hemorrhage in pseudocyst of pancreas. Arch Surg. 1966 Mar;92(3):405–406. doi: 10.1001/archsurg.1966.01320210085018. [DOI] [PubMed] [Google Scholar]
  17. Burbige E. J., Tarder G., Carson S., Eugene J., Frey C. F. Colonic varices. A complication of pancreatitis with splenic vein thrombosis. Am J Dig Dis. 1978 Aug;23(8):752–755. doi: 10.1007/BF01072365. [DOI] [PubMed] [Google Scholar]
  18. Burke J. W., Erickson S. J., Kellum C. D., Tegtmeyer C. J., Williamson B. R., Hansen M. F. Pseudoaneurysms complicating pancreatitis: detection by CT. Radiology. 1986 Nov;161(2):447–450. doi: 10.1148/radiology.161.2.3763917. [DOI] [PubMed] [Google Scholar]
  19. Callet B., Bernades P., Molas G., Dupuy R. Les lésions du foie associées à la pancréatite chronique. Arch Fr Mal App Dig. 1975 Sep;64(6):521–527. [PubMed] [Google Scholar]
  20. Camishion R. C., Pello M. J., Spence R. K., Alexander J. B., Atabek U. M., Kuroda K. Hemoductal pancreatitis. Surgery. 1992 Jan;111(1):86–89. [PubMed] [Google Scholar]
  21. Canakkalelioglu L., Gurkan A. The management of bleeding from a pancreatic pseudocyst: a case report. Hepatogastroenterology. 1996 Jan-Feb;43(7):278–281. [PubMed] [Google Scholar]
  22. Caravati C. M., Ashworth J. S., Frederick P. Pancreatic pseudocysts. A medical evaluation. JAMA. 1966 Aug 15;197(7):572–576. [PubMed] [Google Scholar]
  23. Catalano M. F., Geenen J. E., Schmalz M. J., Johnson G. K., Dean R. S., Hogan W. J. Treatment of pancreatic pseudocysts with ductal communication by transpapillary pancreatic duct endoprosthesis. Gastrointest Endosc. 1995 Sep;42(3):214–218. doi: 10.1016/s0016-5107(95)70094-3. [DOI] [PubMed] [Google Scholar]
  24. Choudhuri G., Tandon R. K., Nundy S., Bhargava D. K. Spontaneous massive gastrointestinal hemorrhage in patients with pancreatitis. Gastroenterol Jpn. 1988 Jun;23(3):318–322. doi: 10.1007/BF02779477. [DOI] [PubMed] [Google Scholar]
  25. Cogbill C. L. Hemorrhage in pancreatic pseudocysts: review of literature and report of two cases. Ann Surg. 1968 Jan;167(1):112–115. doi: 10.1097/00000658-196801000-00018. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Cuschieri A. Laparoscopic surgery of the pancreas. J R Coll Surg Edinb. 1994 Jun;39(3):178–184. [PubMed] [Google Scholar]
  27. Davis C. P., Debatin J. F., Krestin G. P. MR-Angiographie der Becken- und Bauchgefässe. Radiologe. 1994 Aug;34(8):469–476. [PubMed] [Google Scholar]
  28. De Ronde T., Van Beers B., de Cannière L., Trigaux J. P., Melange M. Thrombosis of splenic artery pseudoaneurysm complicating pancreatitis. Gut. 1993 Sep;34(9):1271–1273. doi: 10.1136/gut.34.9.1271. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Dohmoto M., Rupp K. D., Hünerbein M., Schlag P. M. Endoskopische Drainage von Pankreaspseudozysten. Dtsch Med Wochenschr. 1995 Dec 1;120(48):1647–1651. doi: 10.1055/s-2007-1024293. [DOI] [PubMed] [Google Scholar]
  30. Eckhauser F. E., Stanley J. C., Zelenock G. B., Borlaza G. S., Freier D. T., Lindenauer S. M. Gastroduodenal and pancreaticoduodenal artery aneurysms: a complication of pancreatitis causing spontaneous gastrointestinal hemorrhage. Surgery. 1980 Sep;88(3):335–344. [PubMed] [Google Scholar]
  31. Ehrensperger J. Massive bleeding into the upper gastro-intestinal tract in hereditary chronic calcifying pancreatitis in the child. Eur J Pediatr Surg. 1992 Jun;2(3):141–143. doi: 10.1055/s-2008-1063423. [DOI] [PubMed] [Google Scholar]
  32. El Hamel A., Parc R., Adda G., Bouteloup P. Y., Huguet C., Malafosse M. Bleeding pseudocysts and pseudoaneurysms in chronic pancreatitis. Br J Surg. 1991 Sep;78(9):1059–1063. doi: 10.1002/bjs.1800780910. [DOI] [PubMed] [Google Scholar]
  33. Fishman E. K., Soyer P., Bliss D. F., Bluemke D. A., Devine N. Splenic involvement in pancreatitis: spectrum of CT findings. AJR Am J Roentgenol. 1995 Mar;164(3):631–635. doi: 10.2214/ajr.164.3.7863884. [DOI] [PubMed] [Google Scholar]
  34. Flati G., Salvatori F., Porowska B., Talarico C., Flati D., Proposito D., Talarico E., Carboni M. Severe hemorrhagic complications in pancreatitis. Ann Ital Chir. 1995 Mar-Apr;66(2):233–237. [PubMed] [Google Scholar]
  35. Forsmark C. E., Wilcox C. M., Grendell J. H. Endoscopy-negative upper gastrointestinal bleeding in a patient with chronic pancreatitis. Gastroenterology. 1992 Jan;102(1):320–329. doi: 10.1016/0016-5085(92)91818-o. [DOI] [PubMed] [Google Scholar]
  36. Frey C. F. Pancreatic pseudocyst--operative strategy. Ann Surg. 1978 Nov;188(5):652–662. doi: 10.1097/00000658-197811000-00012. [DOI] [PMC free article] [PubMed] [Google Scholar]
  37. Fékété F., Laigneau P., Belghiti J. Les hémorragies digestives au cours des pancréatites chroniques. Gastroenterol Clin Biol. 1980;4(8-9):551–555. [PubMed] [Google Scholar]
  38. Gadacz T. R., Trunkey D., Kieffer R. F., Jr Visceral vessel erosion associated with pancreatitis. Case reports and a review of the literature. Arch Surg. 1978 Dec;113(12):1438–1440. doi: 10.1001/archsurg.1978.01370240060009. [DOI] [PubMed] [Google Scholar]
  39. Garre Sánchez M. C., García Muñoz P., Torrella Cortes E., Alberca de las Parras F., Guillén Pardo B., López Alanis A. Rotura esplénica en una pancreatitis aguda. Gastroenterol Hepatol. 1996 Nov;19(9):462–463. [PubMed] [Google Scholar]
  40. Geller L. I., Bulgakova O. S., Pashko M. M. Techenie i terapiia vnepankreaticheskikh oslozhnenii khronicheskogo pankreatita. Klin Med (Mosk) 1992 May-Jun;70(5-6):30–33. [PubMed] [Google Scholar]
  41. Glaser K., Bodner E., Wetscher G., Weger A., Tschmelitsch J., Klingler P., Pointner R. Hemorrhage from the pancreatic duct caused by a splenic vein fistula. Endoscopy. 1994 Feb;26(2):268–269. doi: 10.1055/s-2007-1008961. [DOI] [PubMed] [Google Scholar]
  42. Greenstein A., DeMaio E. F., Nabseth D. C. Acute hemorrhage associated with pancreatic pseudocysts. Surgery. 1971 Jan;69(1):56–62. [PubMed] [Google Scholar]
  43. Hastings O. M., Jain K. M., Khademi M., Lazaro E. J. Intrasplenic pancreatic pseudocyst complicating severe acute pancreatitis. Am J Gastroenterol. 1978 Feb;69(2):182–186. [PubMed] [Google Scholar]
  44. Henriksen F. W., Hancke S. Percutaneous cystogastrostomy for chronic pancreatic pseudocyst. Br J Surg. 1994 Oct;81(10):1525–1528. doi: 10.1002/bjs.1800811043. [DOI] [PubMed] [Google Scholar]
  45. Hofer B. O., Ryan J. A., Jr, Freeny P. C. Surgical significance of vascular changes in chronic pancreatitis. Surg Gynecol Obstet. 1987 Jun;164(6):499–505. [PubMed] [Google Scholar]
  46. Hoffmeister A. W., Reiter J. Spontane Arrosionsblutungen in Pankreascysten. Chirurg. 1979 Jun;50(6):375–378. [PubMed] [Google Scholar]
  47. Holland G. A., Dougherty L., Carpenter J. P., Golden M. A., Gilfeather M., Slossman F., Schnall M. D., Axel L. Breath-hold ultrafast three-dimensional gadolinium-enhanced MR angiography of the aorta and the renal and other visceral abdominal arteries. AJR Am J Roentgenol. 1996 Apr;166(4):971–981. doi: 10.2214/ajr.166.4.8610584. [DOI] [PubMed] [Google Scholar]
  48. Ikoma A., Tanaka K., Ishibe R., Ishizaki N., Taira A. Late massive hemorrhage following cystogastrostomy for pancreatic pseudocyst: report of a case. Surg Today. 1995;25(1):79–82. doi: 10.1007/BF00309393. [DOI] [PubMed] [Google Scholar]
  49. Isikoff M. B., Hill M. C., Silverstein W., Barkin J. The clinical significance of acute pancreatic hemorrhage. AJR Am J Roentgenol. 1981 Apr;136(4):679–684. doi: 10.2214/ajr.136.4.679. [DOI] [PubMed] [Google Scholar]
  50. Ito Y., Tanegashima A., Nishi K., Sukegawa Y., Kimura H. Necrotizing arteritis causing fatal massive intraperitoneal hemorrhage from a pancreatic pseudocyst. Int J Legal Med. 1994;106(6):324–327. doi: 10.1007/BF01224780. [DOI] [PubMed] [Google Scholar]
  51. Jakobs R., Riemann J. F. Haemosuccus pancreaticus durch ein Druckulcus bei Pankreolithiasis. Dtsch Med Wochenschr. 1992 Dec 22;117(51-52):1956–1961. doi: 10.1055/s-2008-1062536. [DOI] [PubMed] [Google Scholar]
  52. Jeffrey R. B., Jr Sonography in acute pancreatitis. Radiol Clin North Am. 1989 Jan;27(1):5–17. [PubMed] [Google Scholar]
  53. Jenkins A. P., el-Omar M. M., Booth J. C., Banerjee A. K., Burnand K. G., Thompson R. P. Recurrent gastrointestinal bleeding associated with chronic pancreatitis. Gut. 1995 Feb;36(2):314–316. doi: 10.1136/gut.36.2.314. [DOI] [PMC free article] [PubMed] [Google Scholar]
  54. Kiviluoto T., Kivisaari L., Kivilaakso E., Lempinen M. Pseudocysts in chronic pancreatitis. Surgical results in 102 consecutive patients. Arch Surg. 1989 Feb;124(2):240–243. doi: 10.1001/archsurg.1989.01410020114019. [DOI] [PubMed] [Google Scholar]
  55. Kuhn R., Janocha F., Lazar A., Rambach W., Paquet K. J. Rupturiertes Pseudoaneurysma der Arteria lienalis. Komplikation der chronischen Pankreatitis. Dtsch Med Wochenschr. 1996 Dec 13;121(50):1567–1570. doi: 10.1055/s-2008-1043183. [DOI] [PubMed] [Google Scholar]
  56. L'Herminé C., Lemaitre G., Maillard J. P., Toison F. L'hypertension portale segmentaire des pancréatites. Aspects angiographiques. Lille Med. 1971 Aug-Sep;16(7):928–932. [PubMed] [Google Scholar]
  57. Lankisch P. G. The spleen in inflammatory pancreatic disease. Gastroenterology. 1990 Feb;98(2):509–516. doi: 10.1016/0016-5085(90)90848-u. [DOI] [PubMed] [Google Scholar]
  58. Larson P. A., Lipchik E. O., Adams M. B. Development and regression of visceral artery aneurysms following liver transplantation: case report. Cardiovasc Intervent Radiol. 1988 Apr;11(2):75–78. doi: 10.1007/BF02577063. [DOI] [PubMed] [Google Scholar]
  59. Lasson A., Genell S., Nilsson A. Proteolytic activity in pancreatic pseudocyst fluid. Int J Pancreatol. 1994 Jun;15(3):201–208. doi: 10.1007/BF02924195. [DOI] [PubMed] [Google Scholar]
  60. Leger L., Lenriot J. P., Hovasse P. Les hémorragies intra-kystiques des pseudo-kystes pancréatiques. J Chir (Paris) 1976 Feb;111(2):137–162. [PubMed] [Google Scholar]
  61. Leger L., Lenriot J. P., Lemaigre G. L'hypertension et la stase portales segmentaires dans les pancréatites chroniques. A propos de 126 cas examinés par spléno-portographie et spléno-manométrie. J Chir (Paris) 1968 May-Jun;95(5):599–608. [PubMed] [Google Scholar]
  62. Lein B. C., McCombs P. R. Bleeding varices of the small bowel as a complication of pancreatitis: case report and review of the literature. World J Surg. 1992 Nov-Dec;16(6):1147–1150. doi: 10.1007/BF02067083. [DOI] [PubMed] [Google Scholar]
  63. Lesur G., Levy P., Bernades P. La pancréatite chronique de l'homme favorise-t-elle la survenue d'un ulcère duodénal? Gastroenterol Clin Biol. 1991;15(8-9):600–603. [PubMed] [Google Scholar]
  64. Little A. G., Moossa A. R. Gastrointestinal hemorrhage from left-sided portal hypertension. An unappreciated complication of pancreatitis. Am J Surg. 1981 Jan;141(1):153–158. doi: 10.1016/0002-9610(81)90029-5. [DOI] [PubMed] [Google Scholar]
  65. Longstreth G. F., Newcomer A. D., Green P. A. Extrahepatic portal hypertension caused by chronic pancreatitis. Ann Intern Med. 1971 Dec;75(6):903–908. doi: 10.7326/0003-4819-75-6-903. [DOI] [PubMed] [Google Scholar]
  66. Mandel S. R., Jaques P. F., Sanofsky S., Mauro M. A. Nonoperative management of peripancreatic arterial aneurysms. A 10-year experience. Ann Surg. 1987 Feb;205(2):126–128. doi: 10.1097/00000658-198702000-00004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  67. Marescaux J., Evrard S., Aprahamian M., Stock-Damge C., Coumaros D., Sibilly A. Pancreatic lithiasis: a rare cause of gastrointestinal hemorrhage. Surgery. 1989 May;105(5):682–685. [PubMed] [Google Scholar]
  68. Marks I. N., Bank S., Louw J. H., Farman J. Peptic ulceration and gastrointestinal bleeding in pancreatitis. Gut. 1967 Jun;8(3):253–259. doi: 10.1136/gut.8.3.253. [DOI] [PMC free article] [PubMed] [Google Scholar]
  69. Mauro M. A., Jaques P. Transcatheter management of pseudoaneurysms complicating pancreatitis. J Vasc Interv Radiol. 1991 Nov;2(4):527–532. doi: 10.1016/s1051-0443(91)72236-7. [DOI] [PubMed] [Google Scholar]
  70. Moossa A. R., Gadd M. A. Isolated splenic vein thrombosis. World J Surg. 1985 Jun;9(3):384–390. doi: 10.1007/BF01655272. [DOI] [PubMed] [Google Scholar]
  71. Muckart D. J., Bade P. Pancreatic pseudocyst haemorrhage presenting as a bleeding duodenal ulcer. Postgrad Med J. 1989 Oct;65(768):748–749. doi: 10.1136/pgmj.65.768.748. [DOI] [PMC free article] [PubMed] [Google Scholar]
  72. NELSON M. C., SNIDER H. R. Portal hypertension with hemorrhage from esophageal varices secondary to acute recurrent pancreatitis. Surgery. 1956 Dec;40(6):1065–1068. [PubMed] [Google Scholar]
  73. Nogara M. A., Cesar A. M., Kanegusuku J., Lopes R. W. Hemorragia gastrointestinal alta associada à pancreatite crônica e pseudocisto. Relato de um caso. Arq Gastroenterol. 1993 Jan-Mar;30(1):33–37. [PubMed] [Google Scholar]
  74. Pinkas H., Dolan R. P., Brady P. G. Successful endoscopic transpapillary drainage of an infected pancreatic pseudocyst. Gastrointest Endosc. 1994 Jan-Feb;40(1):97–99. doi: 10.1016/s0016-5107(94)70024-9. [DOI] [PubMed] [Google Scholar]
  75. Pitkäranta P., Haapiainen R., Kivisaari L., Schröder T. Diagnostic evaluation and aggressive surgical approach in bleeding pseudoaneurysms associated with pancreatic pseudocysts. Scand J Gastroenterol. 1991 Jan;26(1):58–64. doi: 10.3109/00365529108996484. [DOI] [PubMed] [Google Scholar]
  76. Procacci C., Mansueto G. C., Graziani R., Bicego E., Pederzoli P., Mainardi P., Bergamo-Andreis I. A., Valdo M., Azzolini D. Spontaneous rupture of a pancreatic pseudocyst into the portal vein. Cardiovasc Intervent Radiol. 1995 Nov-Dec;18(6):399–402. doi: 10.1007/BF00338309. [DOI] [PubMed] [Google Scholar]
  77. Puri S. K., Kumar N., Panicker H., Gupta S., Sachdev A. K., Chaudhary A., Broor S. L. Percutaneous catheter drainage in pancreatic pseudocysts. Trop Gastroenterol. 1996 Jul-Sep;17(3):181–184. [PubMed] [Google Scholar]
  78. Pérez C., Llauger J., Pallardó Y., Sanchís E., Sabaté J. M. Radiologic diagnosis of pseudoaneurysms complicating pancreatitis. Eur J Radiol. 1993 Feb;16(2):102–106. doi: 10.1016/0720-048x(93)90005-8. [DOI] [PubMed] [Google Scholar]
  79. Quinn S. F., vanSonnenberg E., Casola G., Wittich G. R., Neff C. C. Interventional radiology in the spleen. Radiology. 1986 Nov;161(2):289–291. doi: 10.1148/radiology.161.2.3763890. [DOI] [PubMed] [Google Scholar]
  80. Rantala A., Ovaska J. Major haemorrhage associated with a pseudocyst in chronic pancreatitis: a gastro-surgical challenge. Ann Chir Gynaecol. 1996;85(3):217–221. [PubMed] [Google Scholar]
  81. Risti B., Marincek B., Jost R., Decurtins M., Ammann R. Hemosuccus pancreaticus as a source of obscure upper gastrointestinal bleeding: three cases and literature review. Am J Gastroenterol. 1995 Oct;90(10):1878–1880. [PubMed] [Google Scholar]
  82. Rösch J. Die Splenoportographie in der Diagnostik der Pankreaserkrankungen. Radiologe. 1965 Aug;5(8):274–281. [PubMed] [Google Scholar]
  83. Sandblom P. Gastrointestinal hemorrhage through the pancreatic duct. Ann Surg. 1970 Jan;171(1):61–66. doi: 10.1097/00000658-197001000-00009. [DOI] [PMC free article] [PubMed] [Google Scholar]
  84. Sankaran S., Walt A. J. The natural and unnatural history of pancreatic pseudocysts. Br J Surg. 1975 Jan;62(1):37–44. doi: 10.1002/bjs.1800620110. [DOI] [PubMed] [Google Scholar]
  85. Santos J. C., Jr, Feres O., Rocha J. J., Aracava M. M. Massive lower gastrointestinal hemorrhage caused by pseudocyst of the pancreas ruptured into the colon. Report of two cases. Dis Colon Rectum. 1992 Jan;35(1):75–77. doi: 10.1007/BF02053343. [DOI] [PubMed] [Google Scholar]
  86. Savides T. J., Gress F., Sherman S., Rahaman S., Lehman G. A., Hawes R. H. Ultrasound catheter probe-assisted endoscopic cystgastrostomy. Gastrointest Endosc. 1995 Feb;41(2):145–148. doi: 10.1016/s0016-5107(05)80597-8. [DOI] [PubMed] [Google Scholar]
  87. Sindelar W. F., Mason G. R. Aortocystoduodenal fistula: rare complication of pancreatic pseudocyst. Arch Surg. 1979 Aug;114(8):953–955. doi: 10.1001/archsurg.1979.01370320085017. [DOI] [PubMed] [Google Scholar]
  88. Singh G., Lobo D. R., Jindal A., Marwaha R. K., Khanna S. K. Splenic arterial hemorrhage in pancreatitis: report of three cases. Surg Today. 1994;24(8):752–755. doi: 10.1007/BF01636785. [DOI] [PubMed] [Google Scholar]
  89. Skarsgard E. D., Ellison E., Quenville N. Spontaneous rupture of a pancreatic pseudocyst into the portal vein. Can J Surg. 1995 Oct;38(5):459–463. [PubMed] [Google Scholar]
  90. Stabile B. E., Wilson S. E., Debas H. T. Reduced mortality from bleeding pseudocysts and pseudoaneurysms caused by pancreatitis. Arch Surg. 1983 Jan;118(1):45–51. doi: 10.1001/archsurg.1983.01390010035009. [DOI] [PubMed] [Google Scholar]
  91. Stambo G. W., Hallisey M. J., Gallagher J. J., Jr Arteriographic embolization of visceral artery pseudoaneurysms. Ann Vasc Surg. 1996 Sep;10(5):476–480. doi: 10.1007/BF02000596. [DOI] [PubMed] [Google Scholar]
  92. Stanley J. C., Frey C. F., Miller T. A., Lindenauer S. M., Child C. G., 3rd Major arterial hemorrhage: a complication of pancreatic pseudocysts and chronic pancreatitis. Arch Surg. 1976 Apr;111(4):435–440. doi: 10.1001/archsurg.1976.01360220131022. [DOI] [PubMed] [Google Scholar]
  93. Starling J. R., Crummy A. B. Hemosuccus pancreaticus secondary to ruptured splenic artery aneurysm. Dig Dis Sci. 1979 Sep;24(9):726–729. doi: 10.1007/BF01314471. [DOI] [PubMed] [Google Scholar]
  94. Steckman M. L., Dooley M. C., Jaques P. F., Powell D. W. Major gastrointestinal hemorrhage from peripancreatic blood vessels in pancreatitis. Treatment by embolotherapy. Dig Dis Sci. 1984 Jun;29(6):486–497. doi: 10.1007/BF01296267. [DOI] [PubMed] [Google Scholar]
  95. Stipa F., Gavelli A., Huguet C. Bleeding pseudocyst of the pancreatic head. The role of omentoplasty and local hemostasis. HPB Surg. 1994;8(2):123–128. doi: 10.1155/1994/23181. [DOI] [PMC free article] [PubMed] [Google Scholar]
  96. Stroud W. H., Cullom J. W., Anderson M. C. Hemorrhagic complications of severe pancreatitis. Surgery. 1981 Oct;90(4):657–665. [PubMed] [Google Scholar]
  97. Suter M., Doenz F., Chapuis G., Gillet M., Sandblom P. Haemorrhage into the pancreatic duct (Hemosuccus pancreaticus): recognition and management. Eur J Surg. 1995 Dec;161(12):887–892. [PubMed] [Google Scholar]
  98. Sutton J. P., Yarborough D. Y., Richards J. T. Isolated splenic vein occlusion. Review of literature and report of an additional case. Arch Surg. 1970 May;100(5):623–626. doi: 10.1001/archsurg.1970.01340230089024. [DOI] [PubMed] [Google Scholar]
  99. Takayama T., Kato K., Katada N., Nishimura D., Shibata T., Kato K., Takeichi M., Yamamoto S., Takeshige K. Radiological demonstration of spontaneous rupture of a pancreatic pseudocyst into the protal system. Am J Gastroenterol. 1982 Jan;77(1):55–58. [PubMed] [Google Scholar]
  100. Targarona E. M., Pera M., Martínez J., Balagué C., Trías M. Laparoscopic treatment of pancreatic disorders: diagnosis and staging, palliation of cancer and treatment of pancreatic pseudocysts. Int Surg. 1996 Jan-Mar;81(1):1–5. [PubMed] [Google Scholar]
  101. Tennøe B., Bay D., Rosales R. Percutaneous drainage of intrasplenic pancreatic pseudocyst. Case report. Acta Radiol. 1996 Mar;37(2):195–197. doi: 10.1177/02841851960371P140. [DOI] [PubMed] [Google Scholar]
  102. Trías M., Targarona E. M., Balagué C., Cifuentes A., Taurá P. Intraluminal stapled laparoscopic cystogastrostomy for treatment of pancreatic pseudocyst. Br J Surg. 1995 Mar;82(3):403–403. doi: 10.1002/bjs.1800820341. [DOI] [PubMed] [Google Scholar]
  103. Tylén U., Arnesjö B. Angiographic diagnosis of inflammatory disease of the pancreas. Acta Radiol Diagn (Stockh) 1973 Mar;14(2):215–240. doi: 10.1177/028418517301400209. [DOI] [PubMed] [Google Scholar]
  104. Vantini I., Piubello W., Scuro L. A., Benini P., Talamini G., Benini L., Micciolo R., Cavallini G. Duodenal ulcer in chronic relapsing pancreatitis. Digestion. 1982;24(1):23–28. doi: 10.1159/000198770. [DOI] [PubMed] [Google Scholar]
  105. Vujic I., Andersen B. L., Stanley J. H., Gobien R. P. Pancreatic and peripancreatic vessels: embolization for control of bleeding in pancreatitis. Radiology. 1984 Jan;150(1):51–55. doi: 10.1148/radiology.150.1.6689787. [DOI] [PubMed] [Google Scholar]
  106. Vujic I. Vascular complications of pancreatitis. Radiol Clin North Am. 1989 Jan;27(1):81–91. [PubMed] [Google Scholar]
  107. Vyborny C. J., Merrill T. N., Reda J., Geurkink R. E., Smith S. J. Subacute subcapsular hematoma of the spleen complicating pancreatitis: successful percutaneous drainage. Radiology. 1988 Oct;169(1):161–162. doi: 10.1148/radiology.169.1.3420253. [DOI] [PubMed] [Google Scholar]
  108. Walter J. F., Chuang V. P., Bookstein J. J., Reuter S. R., Cho K. J., Pulmano C. M. Angiography of massive hemorrhage secondary to pancreatic diseases. Radiology. 1977 Aug;124(2):337–342. doi: 10.1148/124.2.337. [DOI] [PubMed] [Google Scholar]
  109. Warshaw A. L., Jin G. L., Ottinger L. W. Recognition and clinical implications of mesenteric and portal vein obstruction in chronic pancreatitis. Arch Surg. 1987 Apr;122(4):410–415. doi: 10.1001/archsurg.1987.01400160036003. [DOI] [PubMed] [Google Scholar]
  110. White A. F., Baum S., Buranasiri S. Aneurysms secondary to pancreatitis. AJR Am J Roentgenol. 1976 Sep;127(3):393–396. doi: 10.2214/ajr.127.3.393. [DOI] [PubMed] [Google Scholar]
  111. Wiersema M. J. Endosonography-guided cystoduodenostomy with a therapeutic ultrasound endoscope. Gastrointest Endosc. 1996 Nov;44(5):614–617. doi: 10.1016/s0016-5107(96)70022-6. [DOI] [PubMed] [Google Scholar]
  112. Wolstenholme J. T. Major gastrointestinal hemorrhage associated with pancreatic pseudocyst. Am J Surg. 1974 Apr;127(4):377–381. doi: 10.1016/0002-9610(74)90282-7. [DOI] [PubMed] [Google Scholar]
  113. Woods M. S., Traverso L. W., Kozarek R. A., Brandabur J., Hauptmann E. Successful treatment of bleeding pseudoaneurysms of chronic pancreatitis. Pancreas. 1995 Jan;10(1):22–30. doi: 10.1097/00006676-199501000-00003. [DOI] [PubMed] [Google Scholar]
  114. Yale C. E., Crummy A. B. Splenic vein thrombosis and bleeding esophageal varices. JAMA. 1971 Jul 19;217(3):317–320. [PubMed] [Google Scholar]
  115. Zanen A. L., van Vliet A. C., Beukers R. Pancreatic pseudocyst as a cause of upper gastrointestinal bleeding. Neth J Med. 1995 Feb;46(2):90–94. doi: 10.1016/0300-2977(94)00056-f. [DOI] [PubMed] [Google Scholar]
  116. vanSonnenberg E., Casola G., Varney R. R., Wittich G. R. Imaging and interventional radiology for pancreatitis and its complications. Radiol Clin North Am. 1989 Jan;27(1):65–72. [PubMed] [Google Scholar]
  117. von Flüe M., Kocher T., Herzog U., Looser C., Schuppisser J. P. Blutung aus pseudozysten infolge pseudoaneurysma bei chronischer Pankreatitis. Diagnostik und Management. Helv Chir Acta. 1993 Jun;59(5-6):785–789. [PubMed] [Google Scholar]

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