Hemosuccus pancreaticus

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Hemosuccus pancreaticus is a rare but serious medical condition characterized by bleeding from the pancreas into the pancreatic duct, which then drains into the duodenum through the ampulla of Vater. This condition is also known as Wirsungorrhagia.

Etiology

Hemosuccus pancreaticus is often caused by pancreatic pseudocysts, pancreatic tumors, or pancreatitis. Other causes include vascular anomalies such as aneurysms of the splenic artery or other arteries supplying the pancreas.

Pathophysiology

The bleeding in hemosuccus pancreaticus typically originates from the rupture of a pseudoaneurysm or erosion of a blood vessel within the pancreas. The blood then travels through the pancreatic duct and enters the gastrointestinal tract, leading to gastrointestinal bleeding.

Clinical Presentation

Patients with hemosuccus pancreaticus often present with abdominal pain, melena (black, tarry stools), and sometimes hematemesis (vomiting blood). The pain is usually located in the upper abdomen and may radiate to the back. The bleeding can be intermittent, making diagnosis challenging.

Diagnosis

The diagnosis of hemosuccus pancreaticus is often difficult due to its intermittent nature. Endoscopy, angiography, and computed tomography (CT) scans are commonly used diagnostic tools. Endoscopic retrograde cholangiopancreatography (ERCP) can also be helpful in visualizing the pancreatic duct and identifying the source of bleeding.

Treatment

The treatment of hemosuccus pancreaticus depends on the underlying cause. Endovascular embolization is often the first-line treatment for controlling the bleeding. In cases where embolization is not successful, surgical intervention may be required. Pancreatic resection or ligation of the bleeding vessel are potential surgical options.

Prognosis

The prognosis of hemosuccus pancreaticus varies depending on the underlying cause and the success of the treatment. Early diagnosis and prompt treatment are crucial for a favorable outcome.

See Also

• Pancreatitis
• Pancreatic pseudocyst
• Gastrointestinal bleeding
• Endoscopic retrograde cholangiopancreatography