关键词: 急性胰腺炎, 感染性胰腺坏死, 腹腔出血, 消化道出血, 诊断与治疗

Abstract: Diagnosis and treatment of infected pancreatic necrosis complicated with abdominal and gastrointestinal hemorrhage        CAO Fen, LU Jiong-di, LI Fei. Department of General Surgery, Xuanwu Hospital; Clinical Center of Acute Pancreatitis, Capital Medical University, Beijing 100053, China 
Corresponding author: LI Fei, E-mail: feili36@ccmu.edu.cn
Abstract    Hemorrhage is the main cause of late death in patients with infected pancreatic necrosis (IPN). In the course of necrotizing pancreatitis (NP), the necrotic area will be confined or spread and expand, both localized encapsulation and continuous spread of necrosis can invade and compress surrounding organs and blood vessels, leading to intra-abdominal or digestive bleeding. Additionally, Coagulation dysfunction of the patients and surgical intervention increase the risk of bleeding. Common types of intra-abdominal hemorrhage include pseudoaneurysm rupture, cyst hemorrhage, etc. while common types of gastrointestinal bleeding include acute gastric mucosal lesions, ulcer bleeding, pancreatic portal hypertensive bleeding and endoscopic stent-related bleeding. Clinicians should take different treatment measures to improve prognosis based on the patient's condition, bleeding site, and type, while also relying on multidisciplinary diagnosis and treatment. Conservative treatment is only suitable for patients with minor bleeding and stable vital signs, while most patients still need timely endoscopic, interventional embolization or surgical intervention.

Key words: acute pancreatitis, infected pancreatic necrosis, abdominal hemorrhage, gastrointestinal hemorrhage, diagnosis and treatment