Gastrointestinal hemorrhage in the context of complicated acute pancreatitis: a case report
DOI:
https://doi.org/10.62059/w2d9cw81Keywords:
Complicated pancreatitis, Gastrointestinal hemorhage, Pancreatic pseudocystAbstract
The appearance of melena or hematochezia in the clinical context of acute necrotizing pancreatitis leads to urgent determination of its origin. Given this presentation, multiple anatomical origins of bleeding must be considered, not only pancreatic but also its potential early and late complications. We present the case of a patient with history of pancreatitis complicated by a pseudocyst of 2 months' duration and gastrointestinal hemorrhage, presenting with melena and loss of consciousness as the initial clinical manifestation. Given the infrequency of this type of complication in this patient's clinical context, it is worth highlighting the importance of suspecting extraintestinal bleeding when suggestive findings are absent on endoscopy.References
1. Tenner S, Baillie J, DeWitt J, Vege SS. American College of Gastroenterology guideline: management of acute pancreatitis. Am J Gastroenterol. 2013;108(9):1400–15.
2. Pang TCY, Maher R, Gananadha S, Hugh TJ, Samra JS. Peripancreatic pseudoaneurysms: a management-based classification system. Surg Endosc. 2014;28(7):2027–38.
3. de Perrot M, Berney T, Bühler L, Deléaval J, Mentha G, Morel P. Management of bleeding pseudoaneurysms in patients with pancreatitis. Br J Surg. 1999;86(1):29–32.
4. Tessier DJ, Fowl RJ, Stone WM, McKusick MA, Abbas MA, Sarr MG, et al. Clinical features and management of splenic artery pseudoaneurysm: case series and cumulative review of literature. J Vasc Surg. 2003;38(5):969–74.
5. Boudghène F, L’Hermine C, Bigot JM. Arterial complications of pancreatitis: diagnostic and therapeutic aspects in 104 cases. J Vasc Interv Radiol. 1993;4(4):551–8.
6. Pitton MB, Dappa E, Jungmann F, Kloeckner R, Schotten S, Wirth GM, et al. Visceral artery aneurysms: incidence, management, and outcome analysis in a tertiary care center over one decade. Eur Radiol. 2015;25(7):2004–14.
7. Habashi S, Draganov PV. Pancreatic pseudocyst. World J Gastroenterol. 2009;15(1):38–47.
8. Saad NEA, Saad WEA, Davies MG, Waldman DL, Fultz PJ, Rubens DJ. Pseudoaneurysms and the role of minimally invasive techniques in their management. Radiographics. 2005;25(Suppl 1):S173–89.
9. Loffroy R, Favelier S, Pottecher P, Estivalet L, Genson PY, Gehin S, et al. Transcatheter arterial embolization of acute nonvariceal upper gastrointestinal bleeding: indications, techniques and outcomes. Diagn Interv Imaging. 2015;96(7–8):731–44.
10. Carr JA, Cho JS, Shepard AD, Nypaver TJ, Reddy DJ. Visceral pseudoaneurysms due to pancreatic pseudocysts: rare but lethal complications. J Vasc Surg. 2000;32(4):722–30.
Downloads
Status: Under review
in Revista Argentina de MedicinaRAM is a quarterly publication edited and financed by the Argentine Society of Medicine aimed at disseminating biomedical, epidemiological and social scientific topics related to the following branches of clinical medicine: bioethics, cardiology, critical care, palliative care, dermatology, pain, education, emergentology, endocrinology, epidemiology, pharmacology and…
Downloads
Posted
Categories
License
Copyright (c) 2026 Matias Gustavo Maldonado Barrientos, Magdalena Lucía Martin Martinez (Autor/a)
This work is licensed under a Creative Commons Attribution 4.0 International License.
This preprint contains the reported license and associated copyright. Once published in an associated journal or other publisher, the published version assumes the publisher's terms and conditions.
