Hemosuccus pancreaticus due to primary splenic artery aneurysm: a diagnostic and therapeutic challenge

Marco Massani, Alessio Bridda, Ezio Caratozzolo, Luca Bonariol, Michele Antoniutti, Nicolò Bassi
2009 Journal of the Pancreas  
Hemosuccus pancreaticus is a rare cause of upper chronic and intermittent gastrointestinal hemorrhage which cannot be easily detected by endoscopy. 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. The diagnosis is based on direct visualization of the hemorrhage through the main pancreatic duct at angiography. Given its rarity, difficulties in
more » ... , difficulties in determining the source of bleeding can result in delayed treatment. We present a rare case of true splenic artery aneurysm fistulized in the main pancreatic duct and misdiagnosed as a bleeding pancreatic pseudocyst on preoperative examination which included CT and MRCP. Our experience confirms that the diagnosis of bleeding from the main pancreatic duct is very difficult. It requires careful and repeated evaluation by a team of specialists.
pmid:19129615 fatcat:emfodmsjzbbubeudxia3p3grbe