Haemosuccus pancreaticus: treatment by arterial embolization.
OBJECTIVE
Haemosuccus pancreaticus is bleeding into the pancreatic duct from a peripancreatic artery. This condition most commonly follows pseudoaneurysm formation secondary to acute or chronic pancreatitis. It is a rare disorder, challenging in both diagnosis and therapy. We present an eight-year experience of managing these patients using endovascular embolization as the primary therapy.


METHODS
We retrospectively reviewed the imaging, laboratory results and clinical notes of the five patients who presented to this institution between 1991-1999 with gastrointestinal bleeding subsequently found to be haemosuccus pancreaticus.


RESULTS
There were four men and one women aged 38-75 years. All had a history of gastrointestinal haemorrhage and had acute (n=1) or chronic pancreatitis with a complicating pseudoaneurysm. All underwent embolization as the primary therapy for the pseudoaneurysm. There was immediate technical success in all cases without major complication. No patient required operative surgery for the pseudoaneurysm. Follow-up ranged from 18 months to 7 years. One patient died four years after embolization due to hepatic failure but the other four remain well without further gastrointestinal bleeding.


CONCLUSIONS
Endovascular embolization is an effective and safe treatment for haemosuccus pancreaticus.
Dasgupta
R
R
Department of Surgery, Imperial College, Hammersmith Hospital, Du Cane Road, London W12 0NN, UK.
Davies
N J
NJ
Williamson
R C N
RC
Jackson
J E
JE
D000208:Acute Disease; D000328:Adult; D000368:Aged; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D002908:Chronic Disease; D004621:Embolization, Therapeutic; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010192:Pancreatic Pseudocyst / Q000150:complications / Q000000981:diagnostic imaging; D010195:Pancreatitis / Q000150:complications*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed