Case Report
Hemosuccus Pancreaticus with Superior Mesenteric Artery Branch Pseudoaneurysm
Kevin C. Choong and John B. Ammori*Department of Surgery, University Hospitals Case Medical Center, Case Western Reserve University Cleveland, Ohio, USA
- *Corresponding Author:
- John B. Ammori
Department of Surgery
University Hospitals 11100 Euclid Avenue
Cleveland, OH 44106, USA
Tel: 216-844-1777
Fax: 216-286-3294
E-mail: mailto:john.ammori@UHhospitals.org
Received date: September 09, 2014; Accepted date: October 10, 2014; Published date: October 15, 2014
Citation: Choong KC and Ammori JB (2014) Hemosuccus Pancreaticus with Superior Mesenteric Artery Branch Pseudoaneurysm. J Gastroint Dig Syst 4:229. doi:10.4172/2161-069X.1000229
Copyright: © 2014 Choong KC, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Introduction: Hemosuccus pancreaticus is a rare cause of gastrointestinal bleeding due to hemorrhage into the pancreatic duct, most commonly from pseudoaneurysms. Due to its rarity as well as the intermittent nature of the bleeding, diagnosis is commonly delayed. We report an interesting case of hemosuccus pancreaticus and the associated management issues. Case Report: We report a 32 year old man with 3 weeks of progressive melena found to have hemosuccus pancreaticus from an superior mesenteric artery branch pseudoaneurysm as a sequela of pancreatitis. The diagnosis was made with a combination of upper endoscopy, CT angiography. Ultimately this proved to be a management challenge as it required multiple angiographic embolizations to achieve hemostasis. Discussion: Hemosuccus pancreaticus was first coined by Sandblom in 1970. As it presents as gastrointestinal hemorrhage, initial workup is the same, with upper/lower endoscopy and CT angiographies as first line methods. Visceral angiography remains the gold standard for diagnosis of aneurysmal causes. Interventional angiography is the first line treatment of hemosuccus pancreaticus. However if this fails, operative intervention with vessel ligation or formal resection may be required for hemostasis.
