Introduction: Hemosuccus pancreaticus is a rare cause of upper gastrointestinal bleeding and usually occurs as a complication of chronic or acute pancreatitis. Its recognition requires a high clinical suspicious, and sometimes the complementary exams are only suggestive but not definitive for diagnosis. The treatment strategy depends on the cause of the hemosuccus pancreaticus. Case Report: We report a patient with chronic pancreatitis that presented acute abdominal pain and acute upper gastrointestinal bleeding. An upper digestive endoscopy showed an active bleeding from the major duodenal papillae, leading the diagnosing of hemosuccus pancreaticus. An abdominal Angio-CT scan identified a gastroduodenal artery aneurism, followed with embolization of this aneurism. Due to recurrence of bleeding, the patient was submitted to a gastroduodenopancreatectomy, as a rescue measure after embolization failure. Conclusion: The diagnosis for hemosuccus pancreaticus requires a high clinical suspicious, once the visualization of an active bleeding during an upper digestive endoscopy occurs in the minority of cases. Angioembolization is the initial therapy in many cases, but sometimes surgical procedures are mandatory for a definitive treatment.
management. Despite the low incidence rate, choledochal cysts can be associated with many hepatobiliary diseases, including cholangiocarcinoma. The treatment depends on the type of the cyst classified according to the Todani's classification, and has the excision of the cyst as a general principle. There are many options for the biliary tract reconstruction, and some studies have been conducted to compare them. The laparoscopic surgery is a feasible approach (such as the robotic surgery), with the advantage of being a minimally invasive procedure.
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