A rare complication of severe acute pancreatitis: the portal vein compression resulting in uncontrollable gastric ulcer bleeding - a case report.

A rare complication of severe acute pancreatitis: the portal vein compression resulting in uncontrollable gastric ulcer bleeding - a case report. Rev Esp Enferm Dig. 2020 Nov 25;: Authors: Xie J, Wan Y, Liu H Abstract A 43-year-old male with the diagnosis of severe acute pancreatitis (SAP) was admitted to our treatment center. After receiving the step-up approach for 3 weeks, the patient had sudden hematemesis (nearly 400mL). Gastroscopy and computed tomography (CT) were instituted on the same day, revealing gastric ulcer with hemorrhage and the portal vein was extremely compressed by peripancreatic fluid collections in the retroperitoneal space (Fig. 1). Then the patient received medical treatment, endoscopic hemostasis and percutaneous drainage of necrotizing effusion in abdominal cavity. Percutaneous drainage was not effective, which might be ascribed to the incomplete liquefaction of the peripancreatic necrosis. The patient developed gastric ulcer bleeding for 3 times in 1 week. After 1 week of conservative treatment，the walled-off pancreatic necrosis (WOPN) was formed and the complete liquefaction necrosis was showed by CT (Fig. 2). We then performed the minimally invasive necrosectomy for WOPN. After the operation, the upper gastrointestinal bleeding did not occur again. The CT re-examination at the 25 days post-operation showed the necrotic tissue had nearly disappeared, and there was no compression of the portal vein (Fig. ...
Source: Revista Espanola de Enfermedades Digestivas - Category: Gastroenterology Tags: Rev Esp Enferm Dig Source Type: research