摘要
目的 探讨胰源性门脉高压胃底静脉曲张破裂出血并发脾动脉胰管或胰腺假性囊肿胰管出血的发病机制、临床病理特点、诊断和治疗 ,为诊断和处理提供借鉴和参考。方法 回顾性分析我院经治的 2例临床资料 ,并结合文献进行探讨。结果 脾脏、胰尾一并切除 ,效果可靠 ,随访 2年以上无出血。结论 胰源性门脉高压胃底静脉曲张破裂并发胰管出血临床上罕见。慢性胰腺炎史 ,长期间歇性上腹痛及痛后黑便、呕鲜血、脾肿大和肝功能正常是本病的特征。急诊胃十二指肠内窥镜检查和胰胆管逆行造影。
Objective Objective To investigate the pathogenesis, clinicopathological characteristics, diagnosis, and treatment of pancreatogenic portal hypertension, rupture of varicosis of gastric fundus complicated with hemorrhage of splenic artery, pancreatic duct, or pancreatic pseudocyst fistula.Methods Two cases of pancreatogenic portal hypertension complicated with hemorrhage of pancreatic duct and upper digestive tract were analyzed retrospectively with reference to the literature.Results The effectiveness of resection of spleen and cauda pancreatis was reliable and a two year follow-up showed no recurrence of hemorrhage. Conclusions Pancreatogenic portal hypertension with varicosis of gastric fundus complicated with hemorrhage of pancreatic duct and upper digestive tract was clinically rare. The characteristic manifestations of the disease are history of chronic pancreatitis, long term intermittent pain in the epigastric region followed by melena, vomiting of blood, splenomegaly with normal hepatic function. The key steps of diagnosing the disease are gastroduodenal endoscopy, retrograde pancreatocholangiography, and selective splenic arteriography.
出处
《腹部外科》
2002年第6期335-336,共2页
Journal of Abdominal Surgery
