Volume 31 Number 3 (2022)

Hemosuccus Pancreaticus: A Rare Cause of Gastrointestinal Bleeding

Chowdhury MM1 , Quiyum MA2 , Mohammed S3 , Karim R4

Mymensingh Med J 2022 Jul; 31 (3): 872-875

PMID: 35780377

Abstract

Hemosuccus pancreaticus or bleeding from the pancreatic duct into the gastrointestinal tract via the ampulla of Vater is caused by rupture of the pseudoaneurysm of a peripancreatic vessel into pancreatic duct or pancreatic pseudocyst in the context of pancreatitis or pancreatic tumour or trauma. It produces diagnostic and therapeutic dilemma due to its anatomical location and that bleeding into the duodenum is intermittent and cannot be easily diagnosed by endoscopy, often needs CE-CT and angiography. In August 2019, a 60-year-old male presented with intermittent abdominal pain, gastrointestinal bleeding and high serum lipase. Upper GIT endoscopy showed blood mixed bile coming out through ampulla, suspecting Hemosuccus pancreaticus. Contrast-enhanced computed tomography (CT) scan demonstrated pancreatic pseudo cyst with partially thrombosed splenic artery pseudoaneurysm. At laparotomy, splenic artery pseudoaneurysm was ligated along with splenectomy. Later on, the patient had no further occurrence of gastrointestinal bleeding.

Keywords: Hemosuccus pancreaticus, Upper gastrointestinal bleeding, Pancreatitis, Pseudoaneurysm, Angiography, Endoscopy


  1. Professor & Head of the Yellow Unit II

    Hepatobiliary, Pancreatic & Liver Transplant Surgery Department, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh

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Volume 31, Number 3 (2022)
Page: 872-875