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• W2978077072 abstract "Acute pancreatitis results in nearly 250,000 hospital admissions annually and varies widely in its clinical presentation, severity and outcome. Increased morbidity and mortality correlates with advanced degrees of pancreatitis, as well as its complications such as necrosis and pseudocysts. Massive intra-abdominal hemorrhage is an uncommon yet indolent complication, and can be fatal despite aggressive intervention. Here we discuss a case of necrotizing pancreatitis leading to splenic artery rupture and subsequent hemoperitonium. Our patient is a 32 year-old male with a past medical history of daily ETOH use who presented with jaundice and a 4-week history of bilateral lower extremity edema. Physical exam was consistent with stigmata of liver failure with scleral icterus, jaundiced skin and abdominal distention. Laboratory data demonstrated anemia, thrombocytopenia, hyperbilirubinemia, transaminitis and an INR of 1.9. At this time, the patient denied any abdominal pain, however his lipase was elevated to 322 U/L. A new onset of progressive abdominal pain prompted a computerized tomography (CT) scan, which demonstrated necrotizing pancreatitis. Over the course of his stay, a sudden and significant drop in the hemoglobin/hematocrit led to an emergent repeat CT of his abdomen. This revealed hemoperitonium with a large clot adjacent to the pancreas and spleen, consistent with a ruptured splenic artery. Despite early diagnosis, the patient decompensated rapidly. Few case reports of hemoperatonium secondary to acute necrotizing pancreatitis have been identified. The inflammatory process within the pancreas may affect nearby structures such as arterial walls, leading to erosion and subsequently a reputed vessel. Mortality rates based on complications from major vessel erosions of the splenic, gastroduodenal and superior pancreaticoduodenal arteries are 20.5%, 27.9% and 46.1% respectively. Interestingly, patients with hemorrhage associated with pseudocyst formation had the highest survival rates, whereas those with hemorrhage secondary to necrotizing pancreatisis had the poorest. Early recognition and treatment of pancreatitis is key, and recognition of its severity and/or complications such as necrosis should be identified promptly to reduce morbidity and mortality.Figure 1Figure 2" @default.
• W2978077072 created "2019-10-10" @default.
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• W2978077072 date "2016-10-01" @default.
• W2978077072 modified "2023-09-27" @default.
• W2978077072 title "Hemoperitonium: A Rare Yet Severe Complication of Necrotizing Pancreatitis" @default.
• W2978077072 doi "https://doi.org/10.14309/00000434-201610001-01275" @default.
• W2978077072 hasPublicationYear "2016" @default.
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