The prevention and treatment of massive bleeding complicated by severe acute pancreatitis

Abstract

Objective To evaluate the prevention and treatment of massive bleeding complicated by severe acute pancreatitis(SAP).Methods From 1999 to 2008,massive intraabdominal bleeding was encountered in 65 cases out of 790 SAP patients admitted in pancreas surgery center,Union Hospital.Results From 1999.1 to 2003.12.44 out of 387 SAP cases(11.37%)suffered from massive bleeding,among them there were 12 cases of gastrointestinal bleeding and 32 cases of intra-abdominal bleeding.19 cases died of hemorrhage(4.91%);From 2004.1 to 2008.12,severe hemorrhage occurred in 21 out of 403 SAP cases(5.21%),including 8 cases of gastrointestinal bleeding,and 13 cases of intra-abdominal bleeding.5 cases(1.24%)died.The difference of bleeding related morbidity and mortality was statistically significant between these two periods(P<0.01).Conclusions Early and timely enteral nutrition and immunotherapy,effective peritoneal drainage,and appropriate surgical laparotomy were effective measures to decrease the risk of massive bleeding related morbidity and mortality in SAP cases. Key words: Pancreatitis,acute necrotizing; Homorrhage; Enteral nutrition; Drainage