title: Hemosuccus pancreaticus caused by a mucinous cystic neoplasm of the pancreas.
abstract: Hemosuccus pancreaticus is a gastrointestinal hemorrhage through the main pancreatic duct. Here, we report a rare case of hemosuccus pancreaticus due to a mucinous cystic neoplasm of the pancreas. A 62-year-old woman who had been followed for a branch duct intraductal papillary mucinous neoplasm visited our emergency room due to severe abdominal pain and bloody discharge. Computed tomography revealed that the pancreatic cyst increased the tension of the wall and a high-density area indicative of bleeding into the cyst was observed. Endoscopy showed opening of and hemorrhaging from the papilla of Vater. The patient was diagnosed with hemosuccus pancreaticus caused by hemorrhaging into the cyst from the branch duct intraductal papillary mucinous neoplasm. Based on this diagnosis, elective distal pancreatectomy was performed. The histopathological diagnosis was a mucinous cystic neoplasm with intermediate-grade dysplasia based upon the pathological findings that fibrous ovarian-type stroma existed abundantly and the stroma cells were positive for progesterone receptor and inhibin. Hemosuccus pancreaticus caused by a mucinous cystic neoplasm is extremely rare and there has been only one case reported to date. In conclusion, it should be recognized that pancreatic cystic neoplasms including mucinous cystic neoplasms may cause hemosuccus pancreaticus.
authors.affiliation: Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, 770-8503, Japan.
authors.forename: Yuri
authors.initials: Y
authors.lastname: Matsumoto
authors.affiliation: Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, 770-8503, Japan. miyamoto.hiroshi@tokushima-u.ac.jp.
authors.forename: Hiroshi
authors.identifier: http://orcid.org/0000-0002-3715-8894
authors.initials: H
authors.lastname: Miyamoto
authors.affiliation: Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, 770-8503, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Fukuya
authors.affiliation: Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, 770-8503, Japan.
authors.forename: Fumika
authors.initials: F
authors.lastname: Nakamura
authors.affiliation: Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, 770-8503, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Goji
authors.affiliation: Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, 770-8503, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Kitamura
authors.affiliation: Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, 770-8503, Japan.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Kimura
authors.affiliation: Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, 770-8503, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Okamoto
authors.affiliation: Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, 770-8503, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Sogabe
authors.affiliation: Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, 770-8503, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Muguruma
authors.affiliation: Department of Digestive and Pediatric Surgery, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan.
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Shimada
authors.affiliation: Department of Pathology, Tokushima University Hospital, Tokushima, Japan.
authors.forename: Yoshimi
authors.initials: Y
authors.lastname: Bando
authors.affiliation: Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, 770-8503, Japan. takayama@tokushima-u.ac.jp.
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Takayama
mesh_terms: D014670:Ampulla of Vater / Q000000981:diagnostic imaging; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D018297:Neoplasms, Cystic, Mucinous, and Serous / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D010181:Pancreatic Cyst / Q000150:complications / Q000000981:diagnostic imaging; D010183:Pancreatic Ducts; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed
keywords: Hemosuccus pancreaticus; Mucinous cystic neoplasm; Pancreatic cystic neoplasm