An unusual case of late gastrointestinal bleeding after pancreatoduodenectomy

Hemobilia mistaken as gastrointestinal tract bleeding after pancreaticoduodenectomy

“…Post-PPPD hemorrhage is mostly due to the gastroduodenal artery stump erosion derived from pancreatic fistula [1]. Diagnosis of pseudoaneurysm may be established by computed tomography (CT) angiogram or direct visceral angiography in the stable patient emergent operative exploration may be required in the rare case of extreme hemodynamic instability [2]. Sometimes hollow viscus bleeding occurred at the anastomosis site of small bowel between the duodenum and stomach [3].…”