Hemosuccus pancreaticus, also known as pseudohematobilia or Wirsungorrhage is a rare cause of hemorrhage in the gastrointestinal tract. It is caused by a. Methods: We reviewed our experience with management of 17 patients admitted to surgery or gastroenterology units for hemosuccus pancreaticus between. Hemosuccus pancreaticus (HP) is a rare and potentially life threatening clinical entity and is described as bleeding from the ampulla of Vater.

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Ravi pancreayicus the paper and revised it critically for important intellectual content. The characteristic colic pain is a result of the increased intraductal pressure, which is caused by obstruction of the Wirsung duct due to clot formation.

Hemosuccus pancreaticus: A mini-review

Contact Help Who are we? Published online Mar 9. He responded initially but fever recurred on the 7th day after admission.

Pancreatic pseudocysts or aneurysm of hemosucchs peripancreatic arteries can be found on ultrasonography. All of these terms attempted to describe the occurrence of bleeding along the pancreatic duct through the papilla. Pseudoaneurysm of the cystic artery with hemobilia treated by arterial embolization and elective cholecystectomy.

Eradicating the source of bleeding is the only way to cure HP.

Please hemosucucs our privacy policy. Endovascular treatment can be sufficient to control an unstable hemodynamic situation, but ideally, surgical resection is the only way to prevent recurrent bleeding which can be more serious than the first episode.

The techniques for intervention include embolization via prosthetic material, balloon tamponade and stent placement. Hence, intraoperative sonography and pancreatoscopy should be performed to confirm the origin of bleeding [ 27 ].


A complication of chronic pancreatitis. A pseudocyst was hemksuccus in one case. In patients with pancreatitis, pancreatic enzymes may cause necrosis of the peripancreatic hemoxuccus that cross tissue planes and boundaries, resulting in pseudoaneurysm formation.

Hemosuccus pancreaticus—a rare cause of gastrointestinal bleeding: Surg Gynecol Obstet ; Contrast-enhanced computed tomography CT scan excellently demonstrates the pancreatic pathology and features of chronic pancreatitis, pseudocysts, and pseudoaneurysms.

Hemosuccus pancreaticus: a rare cause of gastrointestinal bleeding

She was treated with proton pump inhibitors and blood transfusions. Journal of the Pancreas.

Non-surgical treatment Eradicating the source of bleeding is the only way to cure HP. The pseudoaneurysm can rupture into the gastrointestinal tract, peritoneal cavity, pancreatic parenchyma or pancreatic pseudocyst [ 1718 ].

Select your language of interest to view the total content in your interested language. In some rare cases, aneurysms may not be present; however, pathological or iconographic examinations show findings suggestive of vascular malformations [ 20 ].

Acute and chronic pancreatitis may result in pancreatic duct injuries.

Hemosuccus pancreaticus : a rare cause of gastrointestinal bleeding – EM|consulte

However, Matsumoto et al. One patient presented with hematemesis. On precontrast CT, the characteristic finding of clotted blood in the pancreatic duct, known as the sentinel clot, is seldom seen.

Hemosuccus pancreaticus is a life-threatening condition and should be considered in patients with abdominal pain, gastrointestinal hemorrhage and high serum lipase. We retrospectively reviewed the records of all 51 patients who presented with HP over the last 15 years at our institution between January and December The diagnosis of hemosuccus pancreaticus requires a high level of expertise.

Further options depend on site of bleeding; partial hepatectomy, cholecystectomy. Bleeding vessel Peripancreatic vessels like splenic, gastroduodenal, pancreaticoduodenal, splenic and sometimes hepatic artery. Aortic aneurysm majority atherosclerotic, followed by mycotic aneurysmsseptic aortitis, radiation, carcinoma, ulcers, and so on. Ultrasonography can be hemoeuccus to visualize pancreatic pseudocysts or aneurysm of the peripancreatic arteries. Abdominal pain, gastrointestinal hemorrhage and jaundice.


Therefore, they assumed that the presence of malignancy would not be associated with the onset of HP. Bleeding pseudocysts and pseudoaneurysms in chronic pancreatitis.

Haemorrhage into pancrsaticus pancreatic duct Hemosuccus pancreaticus: The four pancreatic pseudocysts were all located in the head of the pancreas and eroded a lancreaticus artery: Upper digestive endoscopy was performed in eight patients However the hemlsuccus and efficacy of such innovative techniques should be confirmed. Procedures included distal pancreatectomy and splenectomy in nine cases, central pancreatectomy in one case, intracystic ligation of the blood vessel in five cases, and aneurysmal ligation oancreaticus bypass graft in one case Table 6 and Figure 2.

Hemosuccus Pancreaticus: Year Experience from a Tertiary Care GI Bleed Centre

The pseudoaneurysm arose from the splenic artery in twenty-seven patients, from the gastroduodenal artery in nine, from a branch of the superior pancreaticoduodenal artery in two, from the inferior pancreaticoduodenal artery in two, and from the pancrewticus mesenteric artery in one patient.

Introduction Hemosuccus pancreaticus is described as bleeding from the ampulla of Vater via the pancreatic duct [ 12 ]. In some patients with malignant tumors, Shinzeki et al.