Hemosuccus pancreaticus from superior mesenteric artery pseudoaneurysm within perceived pancreatic mass
- 23 Downloads
Bleeding from the pancreatic duct is a rare source of gastrointestinal hemorrhage and is referred to as hemosuccus pancreaticus. Often a result of pseudoaneurysm formation from chronic pancreatitis, hemosuccus pancreaticus is a difficult diagnosis due to its peculiar clinical presentation. This is a case of a 51-year-old male with a history of chronic pancreatitis, who initially presented with a pancreatic mass found on CT scan. The mass was found to be inconclusive for malignancy on endoscopic ultrasound-guided fine needle aspiration. The patient subsequently was lost to follow-up and returned with melena and evidence of a superior mesenteric pseudoaneurysm in the previous mass on CT angiography. The pseudoaneurysm was successfully treated with endovascular embolization. Diagnosis of hemosuccus pancreaticus can be challenging due to the intermittent nature of hemorrhage and the variable clinical presentation—which initially appeared as a pancreatic neoplasm in our patient. Repeat imaging and angiography are invaluable for both the diagnosis and treatment of gastrointestinal bleeding from an unknown source in the setting of chronic pancreatitis.
KeywordsHemosuccus pancreaticus Superior mesenteric artery Pseudoaneurysm Embolization Chronic pancreatitis
Compliance with ethical standards
Conflict of interest
Michelle Shnayder, M.D., M.P.H, and Prasoon Mohan, M.D., declare that they have no conflict of interest.
Research involving human and/or animal rights
All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.
Informed consent was obtained from all patients for being included in the study.
- 2.Ferreira J, Tavares AB, Costa E, et al. Hemosuccus pancreaticus: a rare complication of chronic pancreatitis. BMJ Case Rep. 2015;bcr2015:209–872.Google Scholar
- 3.Kapoor S, Rao P, Pal S, et al. Hemosuccus pancreaticus: an uncommon cause of gastrointestinal hemorrhage. A case report. JOP. 2004;5:373–6.Google Scholar
- 4.Kothari RA, Leelakrishnan V, Krishnan M. Hemosuccus pancreaticus: a rare cause of gastrointestinal bleeding. Ann Gastroenterol. 2013;26:175.Google Scholar
- 5.Maddah G, Abdollahi A, Golmohammadzadeh H, et al. Hemosuccus pancreaticus as a rare cause of gastrointestinal bleeding: a report of two cases. Acta Med Iran. 2015;53:320–3.Google Scholar
- 6.Risti B, Marincek B, Jost R, et al. Hemosuccus pancreaticus as a source of obscure upper gastrointestinal bleeding: three cases and literature review. Am J Gastroenterol. 1995;90:10Google Scholar
- 7.Maisonneuve P, Lowenfels A. Epidemiology and prospects for prevention of pancreatic cancer 2nd edn. In: Neoptolemos J, Urrutia R, Abbruzzese J, Büchler M (eds) Pancreatic cancer. New York, NY: Springer; 2017. pp 1–16Google Scholar
- 11.Nagamatsu H, Takahashi K, Ueo T, et al. A case of splenic artery aneurysm simulating a pancreas tumor. Nihon Shokakibyo Gakkai Zasshi. 2011;108:1420–7.Google Scholar