Hemosuccus pancreaticus--a rare cause of gastrointestinal bleeding: diagnosis and interventional radiological therapy.
Hemorrhage from the pancreatic duct, i.e. hemosuccus pancreaticus (HP), is a rare cause of gastrointestinal bleeding. Pancreatic hemosuccus is usually due to the rupture of an aneurysm of a visceral artery, most likely the splenic artery, in chronic pancreatitis. Other causes of HP are rare. We present a case of HP in a female patient with no history but with positive findings of chronic calcifying pancreatitis upon ultrasonographic investigation, computed tomography scan, and endoscopic retrograde cholangiopancreatography. With detectable fresh blood in the descending duodenum, angiography of the celiac artery revealed an aneurysm of the splenic artery as the suspected cause of intermittent bleeding from the pancreatic duct. The treatment is traditionally surgical or by interventional radiological means. This is the first case described in the literature in which interventional radiological therapy involved implantation of an uncoated metal Palmaz stent in the splenic artery. In the follow-up of 18 months no relapse of HP was observed.
Benz
C A
CA
Department of Gastroenterology, Klinikum der Stadt Ludwigshafen am Rhein, Academic Teaching Hospital of the University of Mainz, Germany. Soyez.Benz@t-online.de
Jakob
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P
Jakobs
R
R
Riemann
J F
JF
D017542:Aneurysm, Ruptured / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D000792:Angiography; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002908:Chronic Disease; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D010179:Pancreas / Q000098:blood supply*; D010183:Pancreatic Ducts; D010195:Pancreatitis / Q000150:complications* / Q000000981:diagnostic imaging; D015642:Radiology, Interventional; D013157:Splenic Artery / Q000000981:diagnostic imaging; D015607:Stents