RESUMO
The authors have analyzed results of treatment of 26 patients with chronic pancreatitis complicated by pseudoaneurysms. Hospitalization and treatment of such patients should be performed in specialized hospitals which can fulfill special examination in detail and carry out roentgen-endovascular operations. Intraintestinal bleeding is an absolute indication for emergent surgery for performing hemostasis. Conservative treatment is indicated for intestinal bleedings and after arrest of bleeding the patients should be transported to specialized institutions. Two types of the appearance of pseudoaneurysms were established depending on the pathological mechanism: when there was a relationship of the pseudocyst with the main pancreatic duct (I type) and when there was not (II type). For the I type roentgen-endovascular treatment (RET) followed by operation is indicated, for the II type RET is thought to be enough.
Assuntos
Falso Aneurisma/complicações , Implante de Prótese Vascular/métodos , Artéria Celíaca , Pancreatectomia/métodos , Pancreatite Crônica/cirurgia , Adulto , Idoso , Falso Aneurisma/diagnóstico , Falso Aneurisma/cirurgia , Angiografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pancreatite Crônica/complicações , Pancreatite Crônica/diagnóstico , Prognóstico , Esplenectomia , Tomografia Computadorizada por Raios X , Ultrassonografia Doppler DuplaRESUMO
20 patients with chronic pancreatitis complicated by development of false aneurysms of arteries in celiac trunk system were observed. Diagnostics utilities included ultrasound study, contrasted computed tomography and angiography. Two types of aneurysms are distinguished: parencchymal and pseudocysts. Radioendovascular operation is the method of choice for aneurism treatment. Surgical treatment is carried out in case of aneurism rupture with voluminous bleeding or on necessity of elimination other complications of chronic pancreatitis (pseudocyst, pancreatic hypertension, wirsungolithiasis).