title: Hemosuccus pancreaticus due to primary splenic artery aneurysm: a diagnostic and therapeutic challenge.
abstract: BACKGROUND
  Hemosuccus pancreaticus is a rare cause of upper chronic and intermittent gastrointestinal hemorrhage which cannot be easily detected by endoscopy. It is usually due to the rupture of a visceral aneurysm into the main pancreatic duct; splenic artery pseudoaneurysm associated with chronic pancreatitis represents the leading cause of this condition. The diagnosis is based on direct visualization of the hemorrhage through the main pancreatic duct at angiography. Given its rarity, difficulties in determining the source of bleeding can result in delayed treatment.
  
  
  METHODS
  We present a rare case of true splenic artery aneurysm fistulized in the main pancreatic duct and misdiagnosed as a bleeding pancreatic pseudocyst on preoperative examination which included CT and MRCP.
  
  
  CONCLUSIONS
  Our experience confirms that the diagnosis of bleeding from the main pancreatic duct is very difficult. It requires careful and repeated evaluation by a team of specialists.
authors.affiliation: Fourth Surgical Division, Regional Hospital Ca' Foncello, Treviso, Italy. mmassani@ulss.tv.it
authors.forename: Marco
authors.initials: M
authors.lastname: Massani
authors.forename: Alessio
authors.initials: A
authors.lastname: Bridda
authors.forename: Ezio
authors.initials: E
authors.lastname: Caratozzolo
authors.forename: Luca
authors.initials: L
authors.lastname: Bonariol
authors.forename: Michele
authors.initials: M
authors.lastname: Antoniutti
authors.forename: Nicolò
authors.initials: N
authors.lastname: Bassi
mesh_terms: D000783:Aneurysm / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D006470:Hemorrhage / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D013157:Splenic Artery / Q000473:pathology