Chonnam Med J.  2005 Aug;41(2):228-232.

A Case of Hemosuccus Pancreaticus Showing Active Bleeding from the Ampulla of Vater

• Park JB
• Jeong JP
• Kim TH
• Kim CH
• Park SW
• Hong GY
• Seo KS
• Lim YK

Abstract

Hemosuccus pancreaticus, meaning hemorrhage through the pancreatic duct into the duodenum, is a rare cause of upper gastrointestinal bleeding. Endoscopy sometimes identifies bleeding from the ampulla of vater and gives important diagnostic clue. Because of high mortality of ruptured pseudoaneurysm, early and precise diagnosis of the disease is critical for management. We report a 69-years old woman with recurrent upper gastrointestinal bleeding due to rupture of pseudoaneurysm into the pancreatic duct. Initial upper gastrointestinal endoscopy failed to identify the site of hemorrhage. Sudden active bleeding from the ampulla of Vater was noted on repeated duodenoscopy. Angiography showed pseudoaneurysm arising from splenic artery and contrast agent passing through the pancreatic duct. Coil embolization was successful in controlling the psdeudoaneurysmal hemorrhage.

Keyword

Hemosuccus pancreaticus; Pseudoaneurysm; Endoscopy; Embolization

MeSH Terms

Aged
Ampulla of Vater*
Aneurysm, False
Angiography
Diagnosis
Duodenoscopy
Duodenum
Embolization, Therapeutic
Endoscopy
Endoscopy, Gastrointestinal
Female
Hemorrhage*
Humans
Mortality
Pancreatic Ducts
Rupture
Splenic Artery