Hemosuccus pancreaticus caused by gastroduodenal artery pseudoaneurysm associated with chronic pancreatitis: A case report and review of literature

Cui, Hai-Yu; Jiang, Cheng-Hang; Dong, Jie; Wen, Yang; Chen, You‐Wei

doi:10.12998/wjcc.v9.i1.236

Cited by 14 publications

(19 citation statements)

References 27 publications

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“…Common entities that could be responsible for HP are chronic or hereditary pancreatitis, which is considered the most common cause. A pancreatic pseudocyst, present in around 10% to 17% of chronic pancreatitis cases, would further increase inflammation (thought to be secondary to an increase in elastase secretion) and cause lysis of the vessels’ wall, resulting in hemorrhage [ 4 ]. Finally, pancreatic tumors can also lead to the development of HP, but the pathophysiology remains unclear to date [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

Hemosuccus Pancreaticus: A Serious Complication of Chronic Pancreatitis

Nasr¹,

Bhutta²,

Kudaravalli³

et al. 2022

Cureus

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Hemosuccus pancreaticus is a rare cause of gastrointestinal bleeding that usually presents with melena and abdominal pain. It is defined as a hemorrhage from the ampulla of Vater passing through the main pancreatic duct toward the second portion of the duodenum. Imaging is usually required to establish a diagnosis, and angiography continues to be the gold standard for both treatment and diagnosis. In some instances where bleeding is uncontrolled or if the patient is unstable, surgery may be required. Physicians should have a high index of suspicion, especially in patients with a history of chronic pancreatitis, as this diagnosis is associated with a very high mortality rate if left untreated. We report a case of a 67-year-old male with a known history of chronic pancreatitis and pancreatic pseudocyst who presented with melena and right upper quadrant abdominal pain and was found to have hemosuccus pancreaticus secondary to a gastroduodenal artery bleed. He underwent successful angiographic embolization and was discharged home after ensuring resolution of bleed and improvement in symptoms.

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Section: Discussionmentioning

confidence: 99%

Hemosuccus Pancreaticus: A Serious Complication of Chronic Pancreatitis

Nasr¹,

Bhutta²,

Kudaravalli³

et al. 2022

Cureus

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“…However, this step may lead to the recurrence of bleeding through the major duodenal papilla. 23 Furthermore, complete or incomplete pancreatic duct blockage can also cause transient hyperamylasemia or hyperbilirubinemia. 23 Gastroduodenal artery pseudoaneurysm may also cause compression of the pancreaticobiliary drainage system, resulting in the aforementioned signs.…”

Section: Discussionmentioning

confidence: 99%

“…23 Furthermore, complete or incomplete pancreatic duct blockage can also cause transient hyperamylasemia or hyperbilirubinemia. 23 Gastroduodenal artery pseudoaneurysm may also cause compression of the pancreaticobiliary drainage system, resulting in the aforementioned signs. 23 The clinical presentation of this patient fits the typical symptoms and signs of hemosuccus pancreaticus.…”

Section: Discussionmentioning

confidence: 99%

Hemosuccus Pancreaticus: A Comprehensive Review of Presentation Patterns, Diagnostic Approaches, Therapeutic Strategies, and Clinical Outcomes

Tarar

Khan

Inayat

et al. 2022

Journal of Investigative Medicine High Impact Case Reports

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Hemosuccus pancreaticus is a rare but potentially torrential and life-threatening cause of acute upper gastrointestinal bleeding. It is described as an intermittent hemorrhage from the major duodenal papilla via the main pancreatic duct. Peripancreatic pseudoaneurysm following chronic pancreatitis is a common underlying etiology. However, gastroduodenal artery pseudoaneurysm-related hemosuccus pancreaticus remains exceedingly rare in the etiological spectrum of upper gastrointestinal bleeding. We hereby delineate a rare case of hemosuccus pancreaticus associated with gastroduodenal artery pseudoaneurysm in a patient who initially presented with abdominal pain and hematochezia. He was successfully managed with coil embolization without recurrence or sequelae. Furthermore, we conducted a search of the MEDLINE (PubMed and Ovid) database for relevant studies on hemosuccus pancreaticus published between inception and September 15, 2021. The available clinical evidence on causes, presentation patterns, diagnosis, and management was analyzed and summarized. This article highlights the rarity, the intermittent nature of hemorrhage, and the lack of a standardized diagnostic approach for this elusive disease. Clinicians should remain cognizant of hemosuccus pancreaticus, especially in patients presenting with symptoms and signs of intermittent gastrointestinal bleeding and abdominal pain. Prompt diagnosis carries paramount importance in saving patients from repeat hospital admissions and disease-associated morbidity and mortality. Conventional angiography with coil embolization may constitute an effective treatment strategy.

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“…A review of the literature and cases between 1977 and 2020 by Cui et al [ 42 ] in 2021 reviewed the variable clinical presentations of HP. GI bleed (melena) was the most commonly reported symptom at 52%, followed by abdominal pain at 46%.…”

Section: Hemosuccus Pancreaticusmentioning

confidence: 99%

“…GI bleed is generally intermittent, likely secondary to clot formation in the pancreatic duct leading to the cessation of GI bleed but persistent abdominal pain. As time passes, clot resolution occurs, leading to rebleeding and abdominal pain improvement due to decreased intraductal pressure[ 42 ].…”

Section: Hemosuccus Pancreaticusmentioning

confidence: 99%

Vascular complications of pancreatitis

Kalas¹,

León²,

Chavez³

et al. 2022

WJCC

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More than 200000 hospital admissions happen per year for acute pancreatitis and more than 50000 for chronic pancreatitis in the United States of America. Necrotizing pancreatitis accounts for 20%-30% of the cases. One-quarter of the patients with pancreatitis develop vascular complications, which carries a high mortality. This mini-review will address these complications that can help primary care physicians and hospitalists in managing their patients effectively.

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Hemosuccus pancreaticus caused by gastroduodenal artery pseudoaneurysm associated with chronic pancreatitis: A case report and review of literature

Cited by 14 publications

References 27 publications

Hemosuccus Pancreaticus: A Serious Complication of Chronic Pancreatitis

Hemosuccus Pancreaticus: A Serious Complication of Chronic Pancreatitis

Hemosuccus Pancreaticus: A Comprehensive Review of Presentation Patterns, Diagnostic Approaches, Therapeutic Strategies, and Clinical Outcomes

Vascular complications of pancreatitis

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