title: Hemosuccus pancreaticus caused by rupture of a splenic artery pseudoaneurysm complicating chronic alcoholic pancreatitis: an uncommon cause of gastrointestinal bleeding.
abstract: We present a case of a 52-year old female patient with intermittent gastrointestinal bleeding and iron deficiency anaemia. Repeated endoscopic investigation revealed no diagnosis, but contrast-enhanced computed tomography showed a splenic artery pseudo-aneurysm secondary to chronic alcoholic pancreatitis. A distal pancreatectomy and splenectomy was performed. Hemosuccus pancreaticus is an uncommon cause of gastrointestinal bleeding, most frequently associated with chronic pancreatitis. Erosion of a peripancreatic artery by a pseudocyst can cause a pseudoaneurysm and rupture occurs in up to 10% of the cases. Bleeding from a pseudocyst wall or rupture of an atherosclerotic or traumatic aneurysm is rare. Angiography, contrast-enhanced computed tomography and endoscopic findings can be diagnostic in the majority of cases. Angiographic embolization or surgery are both therapeutic options depending on underlying nonvascular pancreas related indications requiring surgery. We discuss diagnostic pitfalls and current therapeutic strategies in the management of this disease.
authors.forename: Nick
authors.initials: N
authors.lastname: Hiltrop
authors.forename: Anke
authors.initials: A
authors.lastname: Vanhauwaert
authors.forename: Pieter-Jan Liesbeth Herman
authors.initials: PJ
authors.lastname: Palmers
authors.forename: Mike
authors.initials: M
authors.lastname: Cool
authors.forename: Guido
authors.initials: G
authors.lastname: Deboever
authors.forename: Guy
authors.initials: G
authors.lastname: Lambrecht
mesh_terms: D017541:Aneurysm, False / Q000150:complications*; D017542:Aneurysm, Ruptured / Q000150:complications*; D002908:Chronic Disease; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D008875:Middle Aged; D019512:Pancreatitis, Alcoholic / Q000150:complications*; D013157:Splenic Artery