Top

Published in:

01-08-2019 | Computed Tomography | Case Report

Acute pancreatitis associated with massive bleeding due to a duodenal ulcer

Authors: Daisuke Uchida, Yoshinari Kawai, Hironari Kato, Hiroyuki Okada

Published in: Clinical Journal of Gastroenterology | Issue 4/2019

Abstract

A 74-year-old man presented to the emergency department with acute abdominal pain in addition to anemia and melena, which were suspected to be due to gastrointestinal bleeding. Computed tomography (CT) revealed a blood-filled duodenum and acute pancreatitis. We prioritized treatments for pancreatitis, as the vital signs were stable, and temporary hemostasis was achieved. Two days later, esophagogastroduodenoscopy revealed a duodenal ulcer with an exposed vessel, and endoscopic hemostasis was performed. We urge clinicians to consider the possibility of pancreatitis associated with massive bleeding due to a duodenal ulcer.

Abougergi MS, Travis AC, Saltzman JR. Impact of day of admission on mortality and other outcomes in upper GI hemorrhage: a nationwide analysis. Gastrointest Endosc. 2014;80:228–35.CrossRefPubMed

Choi YH, Yoon SM, Kim EB, et al. A rare case of pancreas divisum accompanied by acute pancreatitis following endoscopic hemostasis for duodenal ulcer bleeding. Korean J Gastroenterol. 2017;69:248–52.CrossRefPubMed

Dibra A, Kellici S, Celiku E, et al. Intramural duodenal hematoma after submucosal injection of epinephrine for a bleeding ulcer: case report and review. G Chir. 2015;36:29–31.PubMedPubMedCentral

Tashima T, Ryozawa S, Ohata K. Rare case of severe acute pancreatitis following over-the-scope clip-assisted duodenal endoscopic mucosal resection using a cap-fitted endoscope in a patient with pancreas divisum. Dig Endosc. 2018;30:679.CrossRefPubMed

Shiozawa K, Watanabe M, Igarashi Y, et al. Acute pancreatitis secondary to intramural duodenal hematoma: case report and literature review. World J Radiol. 2010;2:283–8.CrossRefPubMedPubMedCentral

Laine L, Jensen DM. Management of patients with ulcer bleeding. Am J Gastroenterol. 2012;107:345–60.CrossRefPubMed

Loffroy R, Rao P, Ota S, et al. Embolization of acute nonvariceal upper gastrointestinal hemorrhage resistant to endoscopic treatment: results and predictors of recurrent bleeding. Cardiovasc Intervent Radiol. 2010;33:1088–100.CrossRefPubMed

Romcea AA, Tantau M, Seicean A, et al. The etiology of upper gastrointestinal bleeding in cirrhotic patients. Clujul Med. 2013;86:21–3.PubMedPubMedCentral

Hashizume M, Tanoue K, Ohta M, et al. Vascular anatomy of duodenal varices: angiographic and histopathological assessments. Am J Gastroenterol. 1993;88:1942–5.PubMed

10.

Copelan A, Chehab M, Dixit P, et al. Safety and efficacy of angiographic occlusion of duodenal varices as an alternative to TIPS: review of 32 cases. Ann Hepatol. 2015;14:369–79.CrossRefPubMed

11.

Berry R, Han J, Girotra M, et al. Hemobilia: perspective and role of the advanced endoscopist. Gastroenterol Res Pract. 2018;2018:3670739.CrossRefPubMedPubMedCentral

12.

Yadav D, Lowenfels AB. The epidemiology of pancreatitis and pancreatic cancer. Gastroenterology. 2013;144:1252–61.CrossRefPubMedPubMedCentral

13.

Silva JD, Veloso N, Godinho R, et al. Fatal acute pancreatitis following sclerosis of a bleeding duodenal ulcer complicated by an intramural duodenal hematoma. Rev Esp Enferm Dig. 2012;104:603–4.CrossRefPubMed

14.

Chang CM, Huang HH, How CK. Acute pancreatitis with an intramural duodenal hematoma. Intern Med. 2015;54:755–7.CrossRefPubMed

15.

Sugai K, Kajiwara E, Mochizuki Y, et al. Intramural duodenal hematoma after endoscopic therapy for a bleeding duodenal ulcer in a patient with liver cirrhosis. Intern Med. 2005;44:954–7.CrossRefPubMed

16.

Gonzalez-Gonzalez JA, Garcia-Compean D, Vazquez-Elizondo G, et al. Nonvariceal upper gastrointestinal bleeding in patients with liver cirrhosis. Clinical features, outcomes and predictors of in-hospital mortality. A prospective study. Ann Hepatol. 2011;10:287–95.CrossRefPubMed

Title: Acute pancreatitis associated with massive bleeding due to a duodenal ulcer
Authors: Daisuke Uchida
Yoshinari Kawai
Hironari Kato
Hiroyuki Okada
Publication date: 01-08-2019
Publisher: Springer Japan
Keywords: Computed Tomography
Computed Tomography
Hematoma
Acute Pancreatitis
Gastrointestinal Bleeding
Pancreatitis
Liver Cirrhosis
Duodenal Ulcer
Esophagogastroduodenoscopy
Published in: Clinical Journal of Gastroenterology / Issue 4/2019
Print ISSN: 1865-7257
Electronic ISSN: 1865-7265
DOI: https://doi.org/10.1007/s12328-019-00942-6

ACC 2024 Congress Coverage

Heart Failure Video

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Acute pancreatitis associated with massive bleeding due to a duodenal ulcer

Abstract

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 4/2019

Pancreatic granular cell tumor diagnosed by endoscopic ultrasound-guided fine needle aspiration biopsy

Curative endoscopic treatment of intussusception due to a giant colonic lipoma using a wedged balloon and ligation with detachable snares

Percutaneous transvenous shunt occlusion for portosystemic encephalopathy due to lenvatinib administration to a patient with hepatocellular carcinoma and portosystemic shunt

Surgically resected pancreatic metastasis from nasal malignant melanoma: case report and literature review

Early gastric cancer with ball valve syndrome treated by endoscopic submucosal dissection

Pancreatic cancer and obesity: epidemiology, mechanism, and preventive strategies

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page