2004 Volume 37 Issue 12 Pages 1883-1887
Hemosuccus pancreaticus-blood entering the gastrointestinal tract through the pancreatic duct is rare, and most commonly caused by a pseudoaneurysm of the splenic artery due to acute or chronic pancreatic inflammation. We report hemosuccus pancreaticus caused by a microrupture of the splenic artery with arteriosclerosis into the main pancreatic duct without aneurysms or pancreatic cystic lesions. A 79-year-old man suffering from recurrent hematemesis and melena from July 1996 consulted several hospitals but the cause of gastrointestinal bleeding was not found. In November 2001, endoscopy showed fresh bleeding from the Vaters papillae, and he was diagnosed as hemosuccus pancreaticus. Since we did not detect the hemorrhage locally in angiography near the splenic artery, he did not improve in conservative treatment, so we conducted total pancreatectomy. Histopathologically, the cause of bleeding was a microrupture of the splenic artery with arteriosclerosis into the main pancreatic duct. Hemosuccus pancreaticus is rare, but it is important to treat gastrointestinal bleeding whose origin is not immediately known.
