title: Haemosuccus pancreaticus as a rare initial manifestation of pancreatic carcinoma.
abstract: BACKGROUND
  The major symptoms of cancer of the pancreas, even those of the head, are insidious weight loss, abdominal pains, back pain, anorexia, nausea, vomiting and generalized malaise. Jaundice is present in about 90% of the patients with cancer of the head and 10-40% of those with cancer of body and tail. Massive haemorrhage is an uncommon presentation. Most causes of G. I haemorrhage respond to conservative treatment. Haemosuccus Pancreaticus is a care cause of gastrointestinal hemorrhage and can prove difficult to diagnose.
  
  
  OBJECTIVE
  To highlight the carcinoma of the head of pancreas as a possible cause of massive upper G.I haemorrhage.
  
  
  METHODS
  Case 1: Mr. H. A., a 32 year old man who presented with repeated episodes of massive upper G. I. hemorrhage for which he was transfused on several occasions. He later presented in shock, was resuscitated and had emergency laparatomy. case 2: Miss B.O, A 30 year old lady presented with massive upper G.I hemorrhage not responsive to conservative measures. She had exploratory laparotomy and findings were bleeding pancreatic tumour that eroded into the duodenum.
  
  
  RESULTS
  Both patients were found to have pancreatic caranoma with bleding into the pancreatic ducts.
  
  
  CONCLUSIONS
  Haemosuccus pancreaticus may present as one of the early symptoms of carcinoma of the pancreas in young patients in our environment.
authors.affiliation: Department of Surgery, College of Medicine University of Lagos, Idi-Araba Lagos.
authors.forename: J A
authors.initials: JA
authors.lastname: Ashindoitiang
authors.forename: C C
authors.initials: CC
authors.lastname: Anunobi
authors.forename: O A
authors.initials: OA
authors.lastname: Atoyebi
mesh_terms: D000328:Adult; D002908:Chronic Disease; D003937:Diagnosis, Differential; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D010183:Pancreatic Ducts / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D010195:Pancreatitis / Q000150:complications*; D011859:Radiography