Severe Gastrointestinal Bleeding Due to Hemosuccus Pancreaticus in Chronic Pancreatitis Treated With Percutaneous
Michael Leshen1, Apaar Dadlani2, Nana Ohene-Baah3
1Department of Imaging Sciences, University of Rochester Medical Center, Rochester, NY.
Abstract:
Hemosuccus pancreaticus is a life-threatening but rare cause of intermittent upper gastrointestinal bleeding caused by acute/subacute hemorrhage into a pancreatic duct or pancreatic pseudocyst because of a ruptured pseudoaneurysm. This entity is described in patients with pseudoaneurysms that develop in the context of severe pancreatic/peripancreatic inflammatory changes. Hemosuccus pancreaticus presents a difficult diagnostic and therapeutic conundrum because it tends to involve inflamed, friable, and tortuous vascular pathways. We present a rare case of hemosuccus pancreaticus because of splenic pseudoaneurysm presenting as duodenal hemorrhage and discuss trans-splenic embolization with a combined angiographic and ultrasound-guided approach.
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