Article: article from journal or magazin.
Case report (case report): feedback on an observation with a short commentary.
Hémorragie par le canal de Wirsung: forme rare d'hémorragie digestive haute. A propos d'une observation [Hemorrhage through Wirsung's duct: rare form of upper gastrointestinal hemorrhage. A case report].
Helvetica Chirurgica Acta
Publication types: Case Reports ; English Abstract ; Journal Article Publication Status: ppublish
The case of a 41-year-old alcoholic patient who presented with massive upper gastrointestinal bleeding is reported. The diagnosis was established rapidly by endoscopy which revealed bleeding through the papilla of Vater. Selective angiography of the superior mesenteric artery opacified the pancreatic duct as well as the duodenum. CT scan showed signs of chronic pancreatitis. Because of the recurrence of bleeding and shock, an urgent operation was necessary and a Whipple procedure was performed. Recovery was complete. The clinical presentation, the etiology, the diagnostic modalities and the treatment of this particular condition are discussed. Usually, hemorrhage through the pancreatic duct presents as repeated episodes of upper gastrointestinal bleeding with no source found at endoscopy. The presence of chronic pancreatitis or of epigastric pain during bleeding should suggest the diagnosis. Upper gastrointestinal endoscopy and angiography are the principal diagnostic tools. Definitive treatment requires surgery, and resection in most of the cases.
Adult, Alcoholism/complications, Alcoholism/surgery, Chronic Disease, Gastrointestinal Hemorrhage/etiology, Gastrointestinal Hemorrhage/surgery, Humans, Male, Pancreatic Ducts/surgery, Pancreaticoduodenectomy, Pancreatitis/complications, Pancreatitis/surgery
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