A rare cause of hemosuccus pancreaticus: Primary splenic artery aneurysm ruptured into pancreatic serous cystadenoma

TAVİLOĞLU, Korhan; PINARBAŞI, Binnur; POTUROĞLU, ŞULE; KAYMAKOĞLU, Sbahattin; Akyuz, Filiz; MUNGAN, Zeynel; DİZDAROĞLU, Ferhunde; Gulluoglu, Mine; Yanar, Hakan; Güven, Koray

A rare cause of hemosuccus pancreaticus: Primary splenic artery aneurysm ruptured into pancreatic serous cystadenoma

Binnur PINARBAŞI, (İstanbul Üniversitesi, İstanbul Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, İstanbul, Türkiye)

Şule POTUROĞLU, (İstanbul Üniversitesi, İstanbul Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, İstanbul, Türkiye)

Hakan YANAR, (İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Cerrahi Anabilim Dalı, İstanbul, Türkiye)

Koray GÜVEN, (İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Radyoloji Anabilim Dalı, İstanbul, Türkiye)

Filiz AKYÜZ, (İstanbul Üniversitesi, İstanbul Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, İstanbul, Türkiye)

Ferhunde DİZDAROĞLU, (İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Patoloji Anabilim Dalı, İstanbul, Türkiye)

Mine GÜLLÜOĞLU, (İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Patoloji Anabilim Dalı, İstanbul, Türkiye)

Korhan TAVİLOĞLU, (İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Cerrahi Anabilim Dalı, İstanbul, Türkiye)

Sbahattin KAYMAKOĞLU, (İstanbul Üniversitesi, İstanbul Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, İstanbul, Türkiye)

Zeynel MUNGAN (İstanbul Üniversitesi, İstanbul Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, İstanbul, Türkiye)

Turkish Journal of Gastroenterology

2 0

Yıl: 2008 Cilt: 19 Sayı: 1 Sayfa Aralığı: 57 - 63 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

A rare cause of hemosuccus pancreaticus: Primary splenic artery aneurysm ruptured into pancreatic serous cystadenoma

Öz:

Hemosukkus pankreatikus, peripankreatik bir arterden pankreatik kanal içine kanama olarak tanımlanan nadir bir klinik tablodur. Biz bu yazıda kliniğimize karın ağrısı, koyu renkli dışkılama ve şuur bulanıklığı ile başvuran 57 yaşında bir kadı n hasta sunduk. Ciddi anemisi olması nedeniyle daha ileri incelemeler yapıldı. Bilgisayarlı batın tomografisinde intraabdominal hematom saptandı. Ardından laparatomi yapıldı ve splenik arter anevrizmasının pankreatik seröz kistadenom içine açıldığı, artan kist içi basınçtan dolayı kistin batın içine rüptürüne bağlı intraabdominal hemoraji meydana geldiği belirlendi. Bu ilginç olguya multidisipliner yaklaşım sonucu tanı konuldu.

Anahtar Kelime: Pankreas kanalları Splenik arter Gastrointestinal kanama Kistadenom, seröz Yırtılma, spontan Çölyak arteri Tomografi, x-ışınlı bilgisayarlı Splenektomi Pankreas kisti Kadın Anevrizma, rüptürlü Orta yaşlı Laparotomi Anjiyografi

Konular: Cerrahi

Hemosukkus pankreatikusun nadir bir nedeni: Pankreatik seröz kistadenoma içine primer splenik arter anevrizma rüptürü

Öz:

Hemosuccus pancreaticus is a rare clinical condition defined as bleeding into the pancreatic duct from a peripancreatic artery. We present here a 57-year-old woman admitted to our clinic with abdominal pain, tar-colored stool and confusion. Further investigations were done because of severe anemia. Abdominal computerized tomography revealed intraabdominal hematoma. Laparotomy was performed, which confirmed that intraabdominal haemorrhagia had occurred with the rupture of a splenic artery aneurysm into a pancreatic serous cystadenoma, which ruptured into the abdomen because of high pressure. This is an interesting case diagnosed with multidisciplinary approaches.

Anahtar Kelime: Splenectomy Pancreatic Cyst Female Aneurysm, Ruptured Middle Aged Laparotomy Angiography Pancreatic Ducts Splenic Artery Gastrointestinal Hemorrhage Cystadenoma, Serous Rupture, Spontaneous Celiac Artery Tomography, X-Ray Computed

Konular: Cerrahi

Belge Türü: Makale Makale Türü: Olgu Sunumu Erişim Türü: Erişime Açık

1. White AF, Baum S, Buranasiri S. Aneurysms secondary to pancreatitis. AJR 1976; 127: 393-6.
2. Sandblom P. Gastrointestinal hemorrhage through the pancreatic duct. Ann Surg 1970; 171: 61-6.
3. Sandblom P. Hemobilia (biliary tract hemorrhage): pathology, diagnosis, treatment. Springfield, IL: Charles C Thomas, 1972.
4. Camishion RC, Pello MJ, Spence RK, et al. Hemoductal pancreatitis. Surgery 1992; 111: 86-9.
5. Gore LM, Levine MS. Textbook of gastrointestinal radiology. 2nd ed. Philadelphia: WB Saunders, 2006.
6. Prokkop M, Glanski M. Spiral and multislice tomography of the body. New York, NY: Thieme, 2003.
7. Baum S, Pentecost MJ. Abrams' angiography. Philadelphia: Lippincott Williams and Wilkins, 2006.
8. Le Borgne J, de Calan L, Partensky C. Cystadenomas and cystadenocarcinomas of the pancreas: a multiinstitutional retrospective study of 398 cases. French Surgical Association. Ann Surg 1999; 230(2): 152-61.
9. Macleod AJM, Nichols DM, Munro A, et al. Haemosuccus pancreaticus due to mucinous cystadenocarcinoma: the significance of recurrent abdominal pain, hyperamylasemia and a pancreatic cyst in association with recurrent gastrointestinal bleeding. J R Coll Surg Edinb 1999; 44: 274-6.
10. Boudghene, L'Hermine C, Bigot JM. Arterial complications of pancreatitis: diagnostic and therapeutic aspects in 104 cases. J Vasc Interv Radiol 1993; 4: 551-8.
11. Fiden-Green TC, Turcott JG. Gastrointestinal haemorrhage. New York: Grune and Stratton Inc, 1980.
12. Stanley JC, Fry WJ. Pathogenesis and clinical significance of splenic artery aneurysms. Surgery 1974; 76: 898-909.
13. Shahani RB, Bijlani RS, Dalvi AN, et al. Massive upper gastrointestinal haemorrhage due to direct visceral erosion of splenic artery aneurysm. J Postgrad Med 1994; 40: 220- 2.
14. Wagner WH, Cossman DV, Treiman RL, et al. Hemosuccus pancreaticus from intraductal rupture of a primary splenic artery aneurysm. J Vasc Surg 1994; 19: 158-64.
15. Yokoyama I, Hashmi A, Srinivas D, et al. Wirsungorrhagia or hemoductal pancreatitis: report of case and review of the literature. Am J Gastroenterol 1984; 79: 764-8.
16. Kubo K, Nakamura H, Hirohata Y, et al. Ruptured aneurysm and gastric perforation associated with acute pancreatitis: a rare cause of hematemesis. Gastrointest Endosc 2001; 53: 658-60.
17. Hamel A, Pare R, Adda G, et al. Bleeding pseudocysts and pseudoaneurysms in chronic pancreatitis. Br J Surg 1991; 78: 1059-63.
18. Baruch Y, Levy Y, Goldsher D, et al. Massive haematemesis-- presenting symptoms of cystadenocarcinoma of the pancreas. Postgrad Med J 1989 Jan; 65: 42-4.
19. Williams DM, Shetzline MA, Guarisco SA, et al. Presumed arteriovenous malformation mimicking hemosuccus pancreaticus of Santorini's duct with normal pancreatic anatomy. Gastrointest Endosc 1996; 44: 348-50.
20. Becker WF, Welch RA, Pratt HS. Cystadenoma and cystadenocarcinoma of the pancreas. Ann Surg 1965; 161: 845- 60.
21. Leung KL, Lau WY, Cooper JE, et al. Mucinous cystadenocarcinoma of the pancreas: an uncommon presentation with hemobilia. Gastrointest Endosc 1994; 40: 632-4.
22. Lee NW, Newman BM, Torrance B. Pancreatic cystadenoma. J Roy Coll Surg Edinb 1981; 26: 300-2.
23. Barbee CL, DeMello FB, Grage TB. Cystadenoma of the pancreas. J Surg Oncol 1976; 8: 1-10.
24. Bolondi L, Casanova P. A case of aneurysm of the splenic artery visualized by dynamic ultrasonography. Br J Radiol 1981; 54: 1109-11.
25. Som P, Oster ZH. Detection of gastrointestinal blood loss with 99mTc- labeled, heat-treated red blood cells. Radiology 1981; 138: 207-9.
26. Bowers J, Koehier PR, Hammar SP, et al. Rupture of splenic artery aneurysm into the pancreatic duct. Gastroenterology 1976, 70: 1152-5.
27. Bresler L, Boissel P, Grosdidier J. Major hemorrhage from pseudocysts and pseudoaneurysms caused by chronic pancreatitis: surgical therapy. World J Surg 1991; 15: 649-53.
28. Clay RP, Farnell MB, Lancaster RJ, et al. Hemosuccus pancreaticus. An unusual cause of upper gastrointestinal bleeding. Ann Surg 1985, 202: 75-9.

APA	PINARBAŞI B, POTUROĞLU Ş, Yanar H, Güven K, Akyuz F, DİZDAROĞLU F, Gulluoglu M, TAVİLOĞLU K, KAYMAKOĞLU S, MUNGAN Z (2008). A rare cause of hemosuccus pancreaticus: Primary splenic artery aneurysm ruptured into pancreatic serous cystadenoma. , 57 - 63.
Chicago	PINARBAŞI Binnur,POTUROĞLU ŞULE,Yanar Hakan,Güven Koray,Akyuz Filiz,DİZDAROĞLU Ferhunde,Gulluoglu Mine,TAVİLOĞLU Korhan,KAYMAKOĞLU Sbahattin,MUNGAN Zeynel A rare cause of hemosuccus pancreaticus: Primary splenic artery aneurysm ruptured into pancreatic serous cystadenoma. (2008): 57 - 63.
MLA	PINARBAŞI Binnur,POTUROĞLU ŞULE,Yanar Hakan,Güven Koray,Akyuz Filiz,DİZDAROĞLU Ferhunde,Gulluoglu Mine,TAVİLOĞLU Korhan,KAYMAKOĞLU Sbahattin,MUNGAN Zeynel A rare cause of hemosuccus pancreaticus: Primary splenic artery aneurysm ruptured into pancreatic serous cystadenoma. , 2008, ss.57 - 63.
AMA	PINARBAŞI B,POTUROĞLU Ş,Yanar H,Güven K,Akyuz F,DİZDAROĞLU F,Gulluoglu M,TAVİLOĞLU K,KAYMAKOĞLU S,MUNGAN Z A rare cause of hemosuccus pancreaticus: Primary splenic artery aneurysm ruptured into pancreatic serous cystadenoma. . 2008; 57 - 63.
Vancouver	PINARBAŞI B,POTUROĞLU Ş,Yanar H,Güven K,Akyuz F,DİZDAROĞLU F,Gulluoglu M,TAVİLOĞLU K,KAYMAKOĞLU S,MUNGAN Z A rare cause of hemosuccus pancreaticus: Primary splenic artery aneurysm ruptured into pancreatic serous cystadenoma. . 2008; 57 - 63.
IEEE	PINARBAŞI B,POTUROĞLU Ş,Yanar H,Güven K,Akyuz F,DİZDAROĞLU F,Gulluoglu M,TAVİLOĞLU K,KAYMAKOĞLU S,MUNGAN Z "A rare cause of hemosuccus pancreaticus: Primary splenic artery aneurysm ruptured into pancreatic serous cystadenoma." , ss.57 - 63, 2008.
ISNAD	PINARBAŞI, Binnur vd. "A rare cause of hemosuccus pancreaticus: Primary splenic artery aneurysm ruptured into pancreatic serous cystadenoma". (2008), 57-63.

APA	PINARBAŞI B, POTUROĞLU Ş, Yanar H, Güven K, Akyuz F, DİZDAROĞLU F, Gulluoglu M, TAVİLOĞLU K, KAYMAKOĞLU S, MUNGAN Z (2008). A rare cause of hemosuccus pancreaticus: Primary splenic artery aneurysm ruptured into pancreatic serous cystadenoma. Turkish Journal of Gastroenterology, 19(1), 57 - 63.
Chicago	PINARBAŞI Binnur,POTUROĞLU ŞULE,Yanar Hakan,Güven Koray,Akyuz Filiz,DİZDAROĞLU Ferhunde,Gulluoglu Mine,TAVİLOĞLU Korhan,KAYMAKOĞLU Sbahattin,MUNGAN Zeynel A rare cause of hemosuccus pancreaticus: Primary splenic artery aneurysm ruptured into pancreatic serous cystadenoma. Turkish Journal of Gastroenterology 19, no.1 (2008): 57 - 63.
MLA	PINARBAŞI Binnur,POTUROĞLU ŞULE,Yanar Hakan,Güven Koray,Akyuz Filiz,DİZDAROĞLU Ferhunde,Gulluoglu Mine,TAVİLOĞLU Korhan,KAYMAKOĞLU Sbahattin,MUNGAN Zeynel A rare cause of hemosuccus pancreaticus: Primary splenic artery aneurysm ruptured into pancreatic serous cystadenoma. Turkish Journal of Gastroenterology, vol.19, no.1, 2008, ss.57 - 63.
AMA	PINARBAŞI B,POTUROĞLU Ş,Yanar H,Güven K,Akyuz F,DİZDAROĞLU F,Gulluoglu M,TAVİLOĞLU K,KAYMAKOĞLU S,MUNGAN Z A rare cause of hemosuccus pancreaticus: Primary splenic artery aneurysm ruptured into pancreatic serous cystadenoma. Turkish Journal of Gastroenterology. 2008; 19(1): 57 - 63.
Vancouver	PINARBAŞI B,POTUROĞLU Ş,Yanar H,Güven K,Akyuz F,DİZDAROĞLU F,Gulluoglu M,TAVİLOĞLU K,KAYMAKOĞLU S,MUNGAN Z A rare cause of hemosuccus pancreaticus: Primary splenic artery aneurysm ruptured into pancreatic serous cystadenoma. Turkish Journal of Gastroenterology. 2008; 19(1): 57 - 63.
IEEE	PINARBAŞI B,POTUROĞLU Ş,Yanar H,Güven K,Akyuz F,DİZDAROĞLU F,Gulluoglu M,TAVİLOĞLU K,KAYMAKOĞLU S,MUNGAN Z "A rare cause of hemosuccus pancreaticus: Primary splenic artery aneurysm ruptured into pancreatic serous cystadenoma." Turkish Journal of Gastroenterology, 19, ss.57 - 63, 2008.
ISNAD	PINARBAŞI, Binnur vd. "A rare cause of hemosuccus pancreaticus: Primary splenic artery aneurysm ruptured into pancreatic serous cystadenoma". Turkish Journal of Gastroenterology 19/1 (2008), 57-63.