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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Am J Surg ; The term hemosuccus pancreaticus HP was first proposed by Sandblom inand the term hemoductal pancreatitis was used by Longmire and Rose in As observed in our series, certain authors [ 25 Click here to see the Library et 26 Click here to see the Library ] have reported that patients are free of recurrent bleeding after exclusive endovascular treatment.

HPB Oxford ; The pseudoaneurysm can rupture into the gastrointestinal tract, peritoneal cavity, pancreatic parenchyma or pancreatic pseudocyst [ 1718 ]. It is difficult to diagnose HP because the bleeding is usually intermittent.

Nosazontology Multiple studies have attempted to explain the reason of bleeding. Hemosuccus pancreaticus treated by transvascular selective arterial embolization. Context Hemosuccus pancreaticus is a rare cause of upper gastrointestinal hemorrhage. Selective embolization can be performed before surgery to favor hemodynamic control [ 1 Click here to see the Library15 Click here to see the Library et 19 Click here to see the Library ].

Hemosuccus pancreaticus: a rare cause of gastrointestinal bleeding

Abdominal computed tomography CT was pancrfaticus in three patients Coil embolization techniques provoke a thrombus in the aneurysm but also obliterate the artery [ 19 Click here to see the Library et 23 Click here to see the Library ].


Hemosuccus pancreaticus due to a pressure ulcer in pancreatolithiasis. An unusual cause of upper gastrointestinal bleeding.

Crescendo-decrescendo abdominal pain followed by hemorrhage with a repeat cycle of pain followed by hemorrhage. It identifies the causative artery and helps delineate pancreatcius anatomy for therapeutic interventions. The splenic, common hepatic, gastroduodenal, and pancreaticoduodenal arteries are the areas mostly involved [ 18 ]. Chronic exposure of the arterial wall to digestive enzymes and the pancreaticuz scarring and granulation on the pseudocyst create traction on the vessel, which may trigger GI hemorrhage.

Angiography identifies the causative artery and allows for delineation of the arterial anatomy and therapeutic intervention. Its magnitude varies from occult blood loss to massive life-threatening hemorrhage.

Hemosuccus pancreaticus – Wikipedia

Hemisuccus pancreaticus as a source of obscure upper gastrointestinal bleeding: It is described as bleeding from the ampulla of Vater via the pancreatic duct. Thus, endoscopy is usually not sufficient to make an initial precise diagnosis and a negative endoscopy does not exclude the possibility of hemosusccus pancreaticus.

Seven of the patients with chronic pancreatitis, who had undergone previous embolization, developed intractable pain and needed drainage procedures.

Hemodynamic stability was maintained. They suggested that implantation of a metal stent may be an effective treatment for HP with a low rate of recurrence and complications.

For the patient with chronic familial pancreatitis, active bleeding was not visualized on the angio-CT and no curative treatment was undertaken.

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Pseudocysts have been shown to contain activated lytic enzymes. There was no prior history of liver disease or gastrointestinal bleeding. The abdominal pain is thought to be caused by increased intraductal pressure due to distension of main duct with blood [ 6 ]. Endovascular treatment can be sufficient to control an unstable hemodynamic situation, but ideally, surgical resection is the only way to prevent recurrent bleeding which can be more serious than the first episode.


The diagnosis was established in one other patient undergoing exploration for iron-deficiency anemia. Coil embolization is the most frequently described technique. It is difficult to diagnose HP because the bleeding is usually intermittent. Centralization of GI bleed services along with a multidisciplinary team approach and a pancreaaticus management protocol is essential to reduce the mortality and morbidity of this condition.

Three patients underwent arterial embolization All Published work is licensed under a Creative Commons Attribution 4. HP is a rare and hemosuccjs life-threatening cause of gastrointestinal bleeding. The age pancreatkcus onset is widely distributed; the mean age range of patients with HP is from 32 to 36 years [ [13][14][15] ]. Hemosuccus pancreaticus in a patient with celiac trunk aneurysm. This article has been cited by other articles in PMC.

In patients with pancreatitis, pancreatic enzymes may cause necrosis of the peripancreatic vessels that cross tissue planes and boundaries, resulting in pseudoaneurysm formation. A rare cause of upper gastrointestinal bleeding: In a series of 14 patients with chronic pancreatitis and bleeding pseudocysts, 11 were treated successfully with embolization and 3 needed an operation.

Hemosuccus pancreaticus: a rare cause of gastrointestinal bleeding

A lump was palpable in the epigastric region which was non-pulsatile. Kolkata, West Bengal, India. An upper gastrointestinal endoscopy was performed and bleeding from the papilla was hemosuccys. Pancreatic trauma may result in HP.