title: Two cases of hemosuccus pancreaticus in which hemostasis was achieved by transcatheter arterial embolization.
abstract: Hemosuccus pancreaticus is a rare complication of chronic pancreatitis. We report two cases of hemosuccus pancreaticus in which hemostasis was achieved by transcatheter arterial embolization (TAE). The first patient was a 47-year-old man with alcoholic chronic pancreatitis. He presented with upper abdominal pain and hematemesis. Upper GI endoscopy failed to detect the source of bleeding, but computed tomography (CT) showed a hypervascular area about 3 cm in diameter in a pseudocyst at the pancreatic tail. Angiography revealed a pseudoaneurysm in the caudal pancreatic artery. Hematemesis was considered to be due to rupture of the pseudoaneurysm. TAE of the splenic artery was performed selectively, and this successfully stopped the bleeding. The second patient was a 52-year-old man with alcoholic chronic pancreatitis. He presented with hematemesis. Upper GI endoscopy detected bleeding from the papilla of Vater. CT showed hemorrhage in a pseudocyst at the pancreatic body. Angiography revealed angiogenesis around the pseudocyst. Hematemesis was considered to result from rupture of the pseudoaneurysm. TAE of the dorsal pancreatic artery and posterior superior pancreaticoduodenal artery was performed and hemostasis was achieved. We conclude that TAE is a minimally invasive and highly effective treatment for hemosuccus pancreaticus.
authors.affiliation: Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Sugiki
authors.forename: Takashi
authors.initials: T
authors.lastname: Hatori
authors.forename: Toshihide
authors.initials: T
authors.lastname: Imaizumi
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Harada
authors.forename: Akira
authors.initials: A
authors.lastname: Fukuda
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Kamikozuru
authors.forename: Takehisa
authors.initials: T
authors.lastname: Yazawa
authors.forename: Takeharu
authors.initials: T
authors.lastname: Noguchi
authors.forename: Ken
authors.initials: K
authors.lastname: Takasaki
mesh_terms: D014670:Ampulla of Vater; D002908:Chronic Disease; D004621:Embolization, Therapeutic; D006396:Hematemesis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts; D019512:Pancreatitis, Alcoholic / Q000150:complications*