Hemosuccus pancreaticus from a traumatic gastroduodenal pseudoaneurysm: an unusual cause of upper gastrointestinal bleeding.
Hemosuccus pancreaticus, blood entering the gastrointestinal tract through the pancreatic duct, is a rare and elusive form of gastrointestinal bleeding with diagnostic difficulties. We report a 37-year-old man who had recurrent gastrointestinal bleeding from erosion of a pseudoaneurysm of the gastroduodenal artery into the pancreatic duct. The lack of history of pancreatitis, associated symptoms, equivocal endoscopic findings, and the rarity of this entity resulted in a delay in diagnosis. Pancreatic duct stenosis detected during surgery suggested the lesion might have been caused by blunt abdominal trauma. A nearly total pancreatectomy and splenectomy were performed. The patient remained symptom-free 8 months after the operation. This obscure cause of gastrointestinal bleeding should be considered when common causes of bleeding have been ruled out, even in the absence of pancreatitis.
Chung
H J
HJ
Department of Hepato-Gastroenterology, Chang Gung Memorial Hospital, Taipei, ROC.
Yu
M C
MC
Lien
J M
JM
Jeng
L B
LB
Su
M Y
MY
D000007:Abdominal Injuries / Q000150:complications*; D000328:Adult; D017541:Aneurysm, False / Q000150:complications*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D008297:Male; D010183:Pancreatic Ducts; D010195:Pancreatitis / Q000150:complications*; D014949:Wounds, Nonpenetrating / Q000150:complications*