医学
胃肠病学
门脉高压
内科学
上消化道出血
外科
放射科
胃肠道出血
胰腺
肠系膜上动脉
门静脉压
胰腺炎
食管静脉曲张
作者
Weihua Zhu,Wenyong Xie,Zhedong Zhang,Shengmin Zheng,Dafang Zhang,Shu Li,Ji-ye Zhu
出处
期刊:Chinese Journal of General Surgery
日期:2019-03-25
卷期号:34 (3): 193-195
标识
DOI:10.3760/cma.j.issn.1007-631x.2019.03.001
摘要
Objective
To investigate the diagnosis and treatment of upper gastrointestinal hemorrhage caused by pancreatic segmental portal hypertension.
Methods
The clinical diagnosis and follow-up data of 13 patients with upper gastrointestinal hemorrhage caused by pancreatic segmental portal hypertension from Jan 2010 to Dec 2017 were retrospectively analyzed.
Results
Of the 13 patients, 5 had pancreatic pseudocysts and 8 had chronic pancreatitis. All of them had a history of hematemesis or (and) tarry feces, and 2 of them had a history of hemorrhagic shock. 13 patients had isolated gastric varices, and 5 of them had varicose veins in the lower esophagus. 13 patients had splenomegaly and hypersplenism, and all patients underwent splenectomy. All patients were followed up, and the varicose veins were significantly improved or disappeared. During 1 year to 8 years of follow-up, there was no rebleeding.
Conclusion
Splenectomy cures upper gastrointestinal hemorrhage caused by rupture of the varicose veins in patients of pancreatic segmental portal hypertension. Preoperative interventional spleen artery embolization can reduce the difficulty of spleen resection.
Key words:
Hypertension, portal; Pancreatic diseases; Gastrointestinal hemorrhage
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