Korean J Med.  2016 May;90(5):421-426. 10.3904/kjm.2016.90.5.421.

Recurrent Upper Gastrointestinal Hemorrhage due to Hemosuccus Pancreaticus from True Splenic Artery Aneurysm

• Yoo ES
• Yoo BM
• Yoo EJ
• Yoon SY
• Yang MJ
• Hwang JC
• Kim JH

• KMID: 2163237
• DOI: http://doi.org/10.3904/kjm.2016.90.5.421

Abstract

Hemosuccus pancreaticus, defined as bleeding from the papilla of Vater via the pancreatic duct, is a rare cause of recurrent upper gastrointestinal bleeding. We report the case of a 67-year-old man with recurrent gastrointestinal bleeding, who was subsequently diagnosed with hemosuccus pancreaticus caused by rupture of a true splenic artery aneurysm. The patient had chronic pancreatitis after considerable delay and unnecessary surgical small bowel exploration. The patient was cured with distal pancreatectomy because concomitant arcuate ligament syndrome precluded the angiographic approach via the celiac trunk, and tortuous dilatation of the distal pancreatic duct could not exclude the main duct type of intraductal papillary mucinous neoplasm (IPMN). In the surgical specimen, the pancreatic duct contained a hematoma and was lined by normal epithelium, indicating rupture of the splenic artery aneurysm that bled into the pancreatic duct.

Keyword

Chronic pancreatitis; Gastrointestinal hemorrhage; Splenic artery aneurysm

MeSH Terms

Aged
Aneurysm*
Dilatation
Epithelium
Gastrointestinal Hemorrhage*
Hematoma
Hemorrhage
Humans
Ligaments
Mucins
Pancreatectomy
Pancreatic Ducts
Pancreatitis, Chronic
Rupture
Splenic Artery*
Mucins