DIFFICULTIES AND THE POSSIBILITY OF INTRAOPERATIVE ARREST OF EROSIVE BLEEDING FROM A POSTNECROTIC PANCREATIC CYST

Abstract

Arrosive bleeding of pancreatonecrosis is a rare, however, life-threatening condition due to the lack of a clear arteriographic localization of the source. Most bleeding occurs against the background of infected pancreatic necrosis, as well as pseudocysts of the pancreas, which are formed due to the destruction of the ductal system. The most common causes of hemorrhagic complications of pancreatic necrosis are pseudoaneurysms of vessels involved in the blood supply of the pancreas, with their breakthrough into the free abdominal cavity, retroperitoneal space, into the lumen of the gastrointestinal tract, as well as arrosias of pancreatic vessels involved in the infiltrative inflammatory process. The literature describes isolated cases of endovascular embolization in the treatment of arrosive parapancreatic bleeding in the presence of a round-the-clock angiographic service in a surgical hospital on duty. Today there is no specific management tactics in clinical practice for patients with erosive bleeding from pancreatic cysts, which underlines the urgency of the problem. The observation of intraoperative arrest of arrosive parapancreatic bleeding in a surgical hospital on duty, devoid of round-the-clock angiographic service, is demonstrated. It highlights the difficulties in surgically identifying the source of bleeding and possible solutions.