Reccurent Hemorrhage after Pancreatoduodenectomy Report of a Case Successfully Managed with Operative Hemostasis

• Published in: Nihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine) Vol. 23; no. 6; pp. 905 - 909
• Main Authors: Sasajima, Koji, Miyamoto, Masayuki, Uchida, Eiji, Tajiri, Takashi, Hiroi, Makoto, Nakamuara, Yosiharu, Yamamura, Susumu, Yokoyama, Tadashi, Egami, Kaku, Fukuhara, Munehisa
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society for Abdominal Emergency Medicine 30.09.2003; 日本腹部救急医学会
• Subjects: 腹腔内出血; 膵頭十二指腸切除術; 開腹止血術
• ISSN: 1340-2242; 1882-4781
• DOI: 10.11231/jaem1993.23.905

The patient was a 59 years old man, who was diagnosed as having cancer of the head of the pancreas, and a pancreatoduodenectomy was performed. The postoperative course had been uneventful until shock caused by intra-abdominal hemorrhage occurred on the 16th postoperative day. At laparotomy, a causative injury of the common hepatic artery was found, and it was repaired. Re-bleeding occurre 11 days after the second surgery, however, and the third surgery was performed. The bleeding locus was the same as the previous one, and it was fixed with a transfixing ligation of the common hepatic artery since the vascular wall was severely damaged. Postoperatively, mild impaired liver function was seen, but it recovered within 3 weeks. The patient was discharged on the 88th day from the initial surgery.