title: Haemorrhage into the pancreatic duct (Hemosuccus pancreaticus): recognition and management.
abstract: OBJECTIVE
  To highlight the clinical presentation, investigation and treatment of haemorrhage into the pancreatic duct.
  
  
  METHODS
  Retrospective study and review of publications.
  
  
  METHODS
  University hospital, Switzerland.
  
  
  METHODS
  All 4 cases from 1972 to 1993.
  
  
  METHODS
  2 Whipple procedures, 1 resection of the pancreatic head, 1 exploratory laparotomy. Radiological embolisation in one case.
  
  
  METHODS
  Cessation of haemorrhage and survival.
  
  
  RESULTS
  The diagnosis was made preoperatively in three cases by gastroduodenoscopy and arteriography. Operation was the primary treatment in all patients and was effective with low morbidity and no mortality in three of them. Embolisation stopped the haemorrhage in the fourth patient, who was alcoholic and died of progressive liver insufficiency and variceal haemorrhage.
  
  
  CONCLUSIONS
  There is no specific indication for haemorrhage into the pancreatic duct. The diagnosis is suggested by endoscopy (absence of a more common cause, or blood in the second part of the duodenum). Arteriography is essential to confirm the site of the bleeding and to attempt embolization. Operation is usually the definitive treatment.
authors.affiliation: Department of Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Suter
authors.forename: F
authors.initials: F
authors.lastname: Doenz
authors.forename: G
authors.initials: G
authors.lastname: Chapuis
authors.forename: M
authors.initials: M
authors.lastname: Gillet
authors.forename: P
authors.initials: P
authors.lastname: Sandblom
mesh_terms: D000328:Adult; D000368:Aged; D004621:Embolization, Therapeutic; D017809:Fatal Outcome; D006471:Gastrointestinal Hemorrhage / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts; D010195:Pancreatitis / Q000150:complications; D012189:Retrospective Studies; D016896:Treatment Outcome