Hemosuccus Pancreaticus: A Challenging Diagnosis and Complex Management

Hemosuccus pancreaticus (HP) is an uncommon and infrequently reported cause of upper gastrointestinal bleeding. It is defined as a hemorrhage into the pancreatic duct, which subsequently drains into the duodenum via the ampulla of Vater. The condition is typically associated with underlying pancreatic pathology, such as pancreatitis, pseudocysts, or vascular abnormalities, including splenic artery aneurysms. Clinically, HP presents with intermittent gastrointestinal bleeding, epigastric pain, and a drop in hemoglobin levels; features that often delay diagnosis due to their non-specific and episodic nature. Early recognition is essential, as the condition carries a high risk of morbidity and mortality if not promptly managed. We present a diagnostically challenging case of HP in a frail patient with multiple comorbidities, highlighting the importance of clinical vigilance and multidisciplinary coordination.