Hemosuccus Pancreaticus: Challenging Diagnosis and Treatment

Abstract

Hemosuccus pancreaticus (HP) is defined as bleeding from the ampulla of Vater through the pancreatic duct. It is a rare complication associated with acute or chronic pancreatitis. The source of bleeding can be from the pancreas itself or surrounding vessels, with the splenic artery most commonly involved. Diagnosing HP is challenging and computed tomography angiography remains the gold standard for diagnosis. We present the case of a 62-year-old male with recurrent pancreatitis complicated with HP. Imaging and endoscopy were consistent with bleeding from the section portion of the duodenum, which resolved without intervention.

A Comprehensive Study on the Diagnostic Value of Multi-Slice Computed Tomography for Peripancreatic Infection in Elderly With Severe Acute Pancreatitis

“…In cases of severe pancreatitis, CT typically reveals diffuse or localized pancreatic enlargement with reduced density and thickening of the surrounding fascial area, often accompanied by localized exudation. In contrast, MRI predominantly shows localized or widespread pancreatic enlargement with indistinct contours, accompanied by peripancreatic features such as exudation, bleeding, and mixed long T1 and T2 signal intensities [ 18 ]. However, the diagnostic accuracy of CT and MRI may be compromised by the presence of typical symptoms in severe pancreatitis, including bleeding and exudation, as well as anatomical complexities such as the pseudo-pancreatic head and tail [ 19 ].…”

Hemosuccus pancreaticus as a rare cause of gastrointestinal bleeding

“…Hemosuccus pancreaticus (HP) є проявом різноманітної патології підшлункової залози та/або перипанкреатичних судин [1] і рідкісною причиною кровотечі з верхніх відділів шлунково-кишкового тракту, яка оцінюється в 1 : 1500 випадків, що призводить до складної/ запізнілої діагностики та високої смертності (9,6 і 90 % лише при підтримуючій терапії) [2][3][4]. НР визначається як кровотеча з панкреатичної протоки [5], частіше через великий дуоденальний сосочок, зрідка -малий. Незважаючи на те, що перший випадок НР був описаний We у 1930 р.…”