Progress of Digestive Endoscopy
Online ISSN : 2187-4999
Print ISSN : 1348-9844
ISSN-L : 1348-9844
症例
消化管出血が診断契機となり動脈塞栓術により治療し得たhemosuccus pancreaticusの1例
室井 歩港 洋平石橋 史明上山 俊介外山 雄三村松 雄輔宮本 勇治間野 真也古本 洋平村山 巌一堀内 亮郎淺野 徹佐崎 なほ子忠願寺 義通藤木 和彦
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ジャーナル フリー

2013 年 83 巻 1 号 p. 214-215

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Pancreatic pseudocyst hemorrhage─one of the complications of pancreatitis─is a clinically severe condition, and early diagnosis and appropriate treatment are necessary.
A 62-year-old man with heavy alcohol intake was examined by esophagogastroduodenoscopy (EGD) but no obvious bleeding site was detected. Anemia progressed during follow up and an abdominal CT-scan was performed. Two pancreatic pseudocysts were detected─the one, located at the head of pancreas, showed homogeneous high density, indicating hemorrhage pseudocyst. The patient was again monitored as no active bleeding was suspected; however the anemia worsened. A second EGD was performed and on this occasion red-brown discharge was detected emerging from the orifice of major duodenal papilla. At this point, a diagnosis of hemosuccus pancreaticus caused by pancreatic pseudocyst hemorrhage was made. The gastroduodenal artery was determined by CT angiography to be responsible for the bleeding, and arterial coil embolization was performed. The patient recovered well and no progressive anemia was seen after treatment.
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© 2013 一般社団法人 日本消化器内視鏡学会 関東支部
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