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Major haemorrhagic complications of acute pancreatitis.

Andersson, Ellen LU ; Ansari, D and Andersson, Roland LU (2010) In British Journal of Surgery Jul 1. p.1379-1384
Abstract
BACKGROUND:: Haemorrhage is a rare, potentially fatal complication in acute pancreatitis (AP). The aim was to investigate the incidence, management and outcome related to this complication. METHODS:: The medical records of all patients with AP who presented to a single hospital between January 1994 and July 2009 were reviewed retrospectively. Patients who developed at least one in-hospital episode of major haemorrhage were selected. The aetiology, patient characteristics, occurrence of sentinel bleeding, clinical management and outcome were recorded. RESULTS:: Fourteen (1.0 per cent) of 1356 patients diagnosed with AP developed major haemorrhage. Angiography established the diagnosis in four of six patients. Embolization was successful in... (More)
BACKGROUND:: Haemorrhage is a rare, potentially fatal complication in acute pancreatitis (AP). The aim was to investigate the incidence, management and outcome related to this complication. METHODS:: The medical records of all patients with AP who presented to a single hospital between January 1994 and July 2009 were reviewed retrospectively. Patients who developed at least one in-hospital episode of major haemorrhage were selected. The aetiology, patient characteristics, occurrence of sentinel bleeding, clinical management and outcome were recorded. RESULTS:: Fourteen (1.0 per cent) of 1356 patients diagnosed with AP developed major haemorrhage. Angiography established the diagnosis in four of six patients. Embolization was successful in one patient. Surgery was performed in two patients. Sentinel bleeding occurred in three of four patients with major postoperative bleeding. The overall mortality rate was 36 per cent (5 of 14 patients). Haemorrhage presenting after more than 7 days was associated with a higher mortality rate of 80 per cent (4 of 5 patients). A fatal outcome was at least three times more likely in patients with severe AP and haemorrhagic complications than in those with severe AP but no bleeding. CONCLUSION:: Major haemorrhagic complications of AP are rare, but clinically important. Major postoperative bleeding is often preceded by sentinel bleeding. Intra-abdominal haemorrhage presenting more than 1 week after disease onset is a highly fatal complication. Copyright (c) 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. (Less)
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organization
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type
Contribution to journal
publication status
published
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in
British Journal of Surgery
volume
Jul 1
pages
1379 - 1384
publisher
John Wiley & Sons
external identifiers
  • wos:000280895600011
  • pmid:20564308
  • scopus:77956397215
ISSN
1365-2168
DOI
10.1002/bjs.7113
language
English
LU publication?
yes
id
6631fec8-53fc-4f42-9203-5c0a902f1f13 (old id 1625894)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/20564308?dopt=Abstract
date added to LUP
2010-07-05 21:02:09
date last changed
2018-05-29 11:02:40
@article{6631fec8-53fc-4f42-9203-5c0a902f1f13,
  abstract     = {BACKGROUND:: Haemorrhage is a rare, potentially fatal complication in acute pancreatitis (AP). The aim was to investigate the incidence, management and outcome related to this complication. METHODS:: The medical records of all patients with AP who presented to a single hospital between January 1994 and July 2009 were reviewed retrospectively. Patients who developed at least one in-hospital episode of major haemorrhage were selected. The aetiology, patient characteristics, occurrence of sentinel bleeding, clinical management and outcome were recorded. RESULTS:: Fourteen (1.0 per cent) of 1356 patients diagnosed with AP developed major haemorrhage. Angiography established the diagnosis in four of six patients. Embolization was successful in one patient. Surgery was performed in two patients. Sentinel bleeding occurred in three of four patients with major postoperative bleeding. The overall mortality rate was 36 per cent (5 of 14 patients). Haemorrhage presenting after more than 7 days was associated with a higher mortality rate of 80 per cent (4 of 5 patients). A fatal outcome was at least three times more likely in patients with severe AP and haemorrhagic complications than in those with severe AP but no bleeding. CONCLUSION:: Major haemorrhagic complications of AP are rare, but clinically important. Major postoperative bleeding is often preceded by sentinel bleeding. Intra-abdominal haemorrhage presenting more than 1 week after disease onset is a highly fatal complication. Copyright (c) 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.},
  author       = {Andersson, Ellen and Ansari, D and Andersson, Roland},
  issn         = {1365-2168},
  language     = {eng},
  pages        = {1379--1384},
  publisher    = {John Wiley & Sons},
  series       = {British Journal of Surgery},
  title        = {Major haemorrhagic complications of acute pancreatitis.},
  url          = {http://dx.doi.org/10.1002/bjs.7113},
  volume       = {Jul 1},
  year         = {2010},
}