Case of chronic pancreatic brucellosis presenting as hemosuccus pancreaticus.
BACKGROUND
Hemosuccus pancreaticus is an uncommon cause of upper gastrointestinal bleeding. Chronic infection of the pancreas with Brucellosis causing hemosuccus pancreaticus has not been previously reported.


METHODS
We describe a case of a 75-year-old man presenting with a pancreatic mass and hemosuccus pancreaticus secondary to chronic pancreatic brucellosis. Polymerase chain reaction analysis of the pancreatic tissue was positive for brucella after an initial positive serology. ERCP revealed bleeding from the pancreatic duct. Computed tomography scans of the abdomen demonstrated an enlarging pancreatic mass. Endoscopic ultrasound showed a cystic mass in the body of the pancreas. Fine needle aspiration revealed granulomata. Selective mesenteric angiogram failed to reveal the source of bleeding. The patient eventually underwent pancreatic resection with resolution of symptoms.


CONCLUSIONS
This is the first case of hemosuccus pancreaticus due to chronic pancreatic brucellosis reported in medical literature.
Belo
Angelica C
AC
Baystate Medical Center, Tufts University School of Medicine, Springfield, MA 01199, USA.
Grabowski
Eugene W
EW
Zhang
Chi
C
Longworth
David L
DL
Desilets
David J
DJ
D000368:Aged; D002006:Brucellosis / Q000175:diagnosis*; D003937:Diagnosis, Differential; D006470:Hemorrhage / Q000175:diagnosis*; D006801:Humans; D008297:Male; D010182:Pancreatic Diseases / Q000175:diagnosis*; D050500:Pancreatitis, Chronic / Q000175:diagnosis* / Q000382:microbiology*