Korean J Pancreas Biliary Tract.  2016 Jan;21(1):40-44. 10.15279/kpba.2016.21.1.40.

Hemosuccus Pancreaticus due to Intraductal Pseudoaneurysm

• Lee YJ
• Hyun JJ
• Choi JH
• Sim Y
• Oh HK
• Kim HI
• Lee HS
• Kim CD

• KMID: 2448511
• DOI: http://doi.org/10.15279/kpba.2016.21.1.40

Abstract

Pseudoaneurysm is one of life-threatening complications of chronic or acute pancreatitis. It can lead to massive bleeding into the abdominal cavity, the retroperitoneum, or the gastrointestinal tract. Hemosuccus pancreaticus, meaning hemorrhage through the pancreatic duct into the duodenum is an important diagnostic clue suggesting the presence of pancreatic pseudoaneurysm. A 74-year-old man presented with hematochezia and active bleeding from the ampulla of Vater was noted on upper endoscopy. Abdominal computed tomography scan demonstrated a nodular enhancing lesion within the pancreatic duct. Celiac trunk angiography also showed a nodular enhancing lesion suggesting pseudoaneurysm in the pancreas. However, due to the difficulty of identifying the feeder artery of pseudoaneurysm by selective angiography, embolization was not feasible. Therefore, distal pancreatectomy was performed and ruptured pseudoaneurysm within the pancreatic duct could be confirmed. Herein, we report a case of hemosuccus pancreaticus due to ruptured intraductal pseudoaneurysm that was successfully treated by surgical management.

Keyword

Pancreatitis; Pseudoaneurysm; Hemosuccus pancreaticus; Angiography; Pancreatectomy

MeSH Terms

Abdominal Cavity
Aged
Ampulla of Vater
Aneurysm, False*
Angiography
Arteries
Duodenum
Endoscopy
Gastrointestinal Hemorrhage
Gastrointestinal Tract
Hemorrhage
Humans
Pancreas
Pancreatectomy
Pancreatic Ducts
Pancreatitis