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Updated: Jul 3, 2026
Robotic Duodenum-preserving Total Pancreatic Head Resection for Intraductal Papillary Mucinous Neoplasms
Published on: April 17, 2026
Sequential Pancreatic Ascites and Hemosuccus Pancreaticus from an Identical Rupture Site in Branch-Duct Intraductal
Seiya Sasakura1, Masayoshi Ko1, Takato Maeda1
1Department of Gastroenterology, Aomori Prefectural Central Hospital, Aomori, Japan.
Introduction:
A 68-year-old man with branch-duct intraductal papillary mucinous neoplasm (IPMN) in the pancreatic head presented with pancreatic ascites due to main duct rupture in the pancreatic body without typical pancreatitis symptoms.
Case Presentation:
Although the serum amylase level was elevated, the amylase level in the ascitic fluid was markedly higher. We hypothesize that mucin-induced downstream obstruction may have contributed to elevated intraductal pressure and upstream rupture. After conservative management, the patient developed delayed hemorrhage of approximately 4 months from the same site.
Conclusion:
Based on a PubMed literature search, this appears to be the first reported case of pancreatic ascites followed by delayed hemorrhage from the same site associated with branch-duct IPMN.
