Endovascular management of hemosuccus pancreaticus, a rare case report of gastrointestinal bleeding

BMC Gastroenterology
Hye Ryoung SulByung Kook Kwak

Abstract

Hemorrhage from the pancreatic duct, or hemosuccus pancreaticus (HP), is an unusual cause of intermittent gastrointestinal bleeding. HP is most often diagnosed in patients with chronic pancreatitis, and is usually due to the rupture of an aneurysm in the splenic artery. The traditional treatment for HP is surgery, although most cases can be managed by angioembolization. We present a case of HP in a patient with no history or evidence of chronic pancreatitis. Repeated endoscopy revealed fresh bleeding from the papilla of Vater. Angiography revealed an aneurysm of the splenic artery, which was the suspected cause of the intermittent bleeding from the pancreatic duct. Angiography demonstrated extravasation of contrast from the aneurysm. A peripheral Jostent stent-graft was hand-mounted on an angioplasty balloon and then inserted into the aneurysm. Arteriography revealed successful occlusion of the aneurysm with the stent-graft. No recurrent gastrointestinal bleeding was observed during the five years follow-up periods. HP should be included in the differential diagnosis of intermittent gastrointestinal bleeding in patients with histories of chronic alcoholism, even when they do not have a history of chronic pancreatitis. We recomm...Continue Reading

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Citations

Jun 27, 2018·Vascular and Endovascular Surgery·Takafumi OuchiHajime Sakuma
Aug 30, 2018·Journal of Vascular Surgery·Rhusheet Patel, Mark Girgis
Jun 24, 2017·Journal of Clinical Gastroenterology·Scott CathcartMicheal Schuster

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