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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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Other causes Pancreatic trauma may result in HP. Hemosuccus pancreaticus caused by a mucinous cystic neoplasm of the pancreas.

Hemosuccus yemosuccus is a rare cause of pancreatic bleeding, the prevalence being much lower than for segmentary portal hypertension or duodenal ulceration. Ischemia can develop in the tissue supplied by the artery if the collateral circulation is insufficient, if the thrombosis is too extensive or if the embolization material migrates.

Hemosuccus Pancreaticus: A Mysterious Cause of Gastrointestinal Bleeding

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Hemosuccus pancreaticus HP could be an extremely rare disease. EUS showing evidence of chronic pancreatitis with inflammatory mass arrow head showing inflammatory mass.

Improved outcomes in postoperative and pancreatitis-related visceral pseudoaneurysms. Aneurysm and chronic pancreatitis are often associated but no causal relationship has been clearly established [ 9 Rohner A. An arterial abnormality was found to be at pancreatifus in five patients After removal of the clots and slight pressure on the blister-like area, arterial bleeding was seen which was controlled with polypropylene sutures.

Top of the page – Article Outline. It is usually due to the rupture of a visceral aneurysm into the main pancreatic duct; splenic artery pseudoaneurysm associated with chronic pancreatitis represents the leading cause of this condition [ 1 – 3 ]. Ravichandran gave the final approval of the version to be published. Manifestation The age of onset is widely distributed; the hemosuccjs age range of patients with HP is from 32 to 36 years [ [13][14][15] ].


Therefore, they assumed that the presence of malignancy would not be associated with the onset of HP. Eur J Surg ; Trial registry number None. From Wikipedia, the free encyclopedia.

The techniques for pancgeaticus include embolization via prosthetic material, balloon tamponade and stent placement. Hemosuccus pancreaticus after endoscopic ultrasound-guided fine needle aspiration of a pancreatic cyst. The arteries involved in the gastrointestinal hemorrhage in yemosuccus order hemosuccu frequency include: Contrast CT scan the most diagnostic. Abdominal ultrasonography was performed in two patients and enabled the diagnosis of aneurismal bleeding from the splenic artery in one case and a cyst fistulized into an artery in the head of the pancreas in another.

A lump was palpable in the epigastric region which was non-pulsatile. Contrast-enhanced CT is an excellent modality for demonstrating the pancreatic pathology and can also demonstrate features of chronic pancreatitis, pseudocysts, and pseudoaneurysms.

The key symptom of HP is melena, which is the most common.

The bleeding is usually intermittent, repetitive, and often not severe enough to ehmosuccus a hemodynamic instability. In the event of continued destabilization or failed angioembolization, the patient was taken up for emergency surgery. Major hemorrhage associated with a pseudocyst in chronic pancreatitis: International Scholarly Research Notices. A year-old male with a history of chronic alcoholism having a 3-week history of alcohol-related severe acute pancreatitis was referred to our institution for a necrosectomy.

Endoscopic ultrasound showed chronic pancreatitis with a heterogeneous inflammatory lesion in the body of the pancreas Fig. The cause is a transient increase in intraductal pressure by a blood clot. Definition HP is defined as bleeding from the ampulla of Vater via the pancreatic duct.

J Vasc Interv Radiol ; 4: Also, the cause of bleeding may be too diffuse to be treated with embolization such as with pancreatitis or with pancreatic cancer.

Bleeding from the duct of Santorini can be caused by pancreas divisuma possible congenital cause of pancreatitis. On precontrast CT, the characteristic finding of clotted blood in the pancreatic duct, known as the sentinel clot, is seldom seen. Angioembolization failed due to technical reasons partial embolization due to a rich collateral supply and the patient pancreeaticus to panncreaticus emergency surgery.


Abstract Determining the cause of obscure bleeding in the gastrointestinal tract is the key in treating the disease. It can pose a significant diagnostic and therapeutic dilemma due to its anatomical location and that bleeding into the duodenum is intermittent and cannot be easily diagnosed by endoscopy.

Gastroenterol Clin Biol ; The pain is described as being pnacreaticus in nature, meaning that it increases and decreases in intensity slowly with time.

Hemosuccus pancreaticus

A year-old male diagnosed case of ethanol-related chronic pancreatitis presented with frequent episodes of melena associated with paroxysms of abdominal pain. The former is termed Wirsungorrhage and the latter is termed Santorinirrhage. The treatment technique included a superselective catheterization of the feeding artery, followed by endosaccular treatment of the pseudoaneurysm.

Management of bleeding pseudoaneurysms in patients with pancreatitis. Hepatobiliary Pancreat Dis Int.

Hemosuccus Pancreaticus: A Mysterious Cause of Gastrointestinal Bleeding

Source Pancreas, pancreatic pseudocyst. Angiography identifies the causative artery and allows for delineation of the arterial anatomy and therapeutic intervention [ 912 — 16 ]. An esophagogastroduodenal hemowuccus study was performed in one patient and only demonstrated a widened duodenum. Hemosuccus pancreaticus in a patient with celiac trunk aneurysm.

A pancreatic pseudocyst possesses a significant relationship with the pancreatic duct, and bleeding in the gastrointestinal tract may also occur entirely through this route [ 31 ].

Other pancreatic causes of hemosuccus pancreaticus are rare: The age of onset is widely distributed; the mean age range of patients with HP is from 32 to 36 years [ [13][14][15] ].