[A case report of hemosuccus pancreaticus caused by a ruptured splenic aneurysm]

A 65-year-old female with hematemesis due to hemosuccus pancreaticus observed by endoscopy was reported. Selective angiography demonstrated 4 aneurysms of the splenic artery ramificated from the superior mesenteric artery (SMA). Of these 4 aneurysms, the largest one was located at 5mm distal from the SMA ruptured into the pancreatic duct. Resection of the splenic aneurysms, splenectomy and cholecystectomy for concomitant gallstone were successfully performed and the patient had no further gastrointestinal bleeding. True aneurysms with marked arteriosclerosis were confirmed histopathologically. Of 48 cases of hemosuccus pancreaticus reported in the literature, 15 cases caused by ruptured true aneurysms were reviewed. Pathogenesis, diagnosis and surgical procedure for this rare syndrome were discussed.