Endoscopic Ultrasound-assisted Diagnosis of Obscure Gastrointestinal Bleeding

Hemosuccus pancreaticus (HP) describes hemorrhage originating from the pancreatic duct. HP is an extremely uncommon source of upper gastrointestinal bleeding and is often misdiagnosed in most community hospitals. HP is believed to be associated with arterial aneurysm, pancreatitis (acute or chronic), local inflammation, pseudocyst, and tumor or cystic neoplasms. We report a case of a 62-year-old man with multiple cysts in the pancreas on CT scan who presented with an obscure upper GI bleed in which we performed step-wise investigations that led us to the diagnosis of hemosuccus pancreaticus, which was made through endoscopic ultrasound. After diagnosis, the patient was treated successfully by interventional radiology.