Author/Editor		Skok, Pavel; Sinkovič, Andreja
Title		Neobičajen vzrok krvavitve v trebušno votlino - prikaz primera iz klinične prakse
Translated title		Unusual cause of hemorrhage into abdominal cavity - a case report from clinical practice
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 68, št. 7-8
Publication year		1999
Volume		str. 409-11
Language		slo
Abstract		Background. Acute hemorrhage due to pseudocyst of the pancreas is a life endangering complication of chronic pancreatitis. Without operative treatment mortality is as high as 90%. Immediate recognition of this complication as well as urgent operative treatment allowing the survival of 70% of patients is imperative. Case report. Described is the case of patient with chronic pancreatitis and pseudocyst in which hyperamylasemia and unclarifed anemia developed following sudden abdominal cavity was confirmed by selective viscelar angiography showing hemorrhage from the splenic artery in the region of the hilus of the spleen. Operative treatment was successful. During the procedure, a ligature was applied to the hemorrhaging splenic artery and a splenectomy was carried out, 2500 ml of bloody contents were removed from the abdominal cavity. Conclusions. Acute hemorrhage into the peritoneal cavity as a complication of chronic pancreatitis with pseudocyst requies immediate identification, confirmation by visceral angiography and urgent operative treatment.
Summary		Izhodišča. Akutna krvavitev zaradi pseudociste trebušne slinavke je življenje ogrožujoč zaplet kroničnega pankreatitisa. Brez operativnega zdravljenja je umrljjivost do 90%. Takojšnje prepoznavanje tega zapleta in nujno operativno zdravljenje omogoči preživetje 70% bolnikom. Prikaz primera. Opisan je primer bolnika s kroničnim pankreatitisom in pseudocisto, ki je ob nenadnih bolečinah v trebuhu razvil povišano aktivnost amilaze v serumu in nepojasnjeno anemijo. Sum na krvavitev v trebušno votlino smo potrdili s selektivno angiografijo drobovja, ki je potrdila krvavitev iz vranične arterije v predelu vranične line. Bolnik je bil uspešno operativno zdravljen. Pri operativnem posegu so podvezali krvavečo vranično arterijo, odstranili vranico, iz trebušne votline pa so posrkali tudi 2500 ml krvave vsebine. Zaključki. Akutno krvavitev v trebušno votlino kot zaplet kroničnega pankreatitisa s pseudocisto je treba takoj prepoznati, dokazati z angiografijo drobovja in nujno operativno zdraviti.
Descriptors		PANCREATITIS, ALCOHOLIC HEMORRHAGE PANCREATIC CYST ANGIOGRAPHY SLOVENIA ABDOMINAL PAIN