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Clinical Journal of Gastroenterology

, Volume 12, Issue 1, pp 88–91 | Cite as

Hemosuccus pancreaticus from superior mesenteric artery pseudoaneurysm within perceived pancreatic mass

  • Michelle Maggie ShnayderEmail author
  • Prasoon Mohan
Case Report
  • 23 Downloads

Abstract

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.

Keywords

Hemosuccus pancreaticus Superior mesenteric artery Pseudoaneurysm Embolization Chronic pancreatitis 

Notes

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

Informed consent was obtained from all patients for being included in the study.

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Copyright information

© Japanese Society of Gastroenterology 2018

Authors and Affiliations

  1. 1.Department of Medical Education, Leonard M. Miller School of MedicineUniversity of Miami, Miller School of MedicineMiamiUSA
  2. 2.Department of Vascular and Interventional RadiologyJackson Memorial Medical CenterMiamiUSA

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