A case of pancreatic pseudocyst hemorrhage caused by hemosuccus pancreaticus and treated using arterial coil embolization

Abstract

Pancreatic pseudocyst hemorrhage─one of the complications of pancreatitis─is a clinically severe condition, and early diagnosis and appropriate treatment are necessary.
A 62-year-old man with heavy alcohol intake was examined by esophagogastroduodenoscopy (EGD) but no obvious bleeding site was detected. Anemia progressed during follow up and an abdominal CT-scan was performed. Two pancreatic pseudocysts were detected─the one, located at the head of pancreas, showed homogeneous high density, indicating hemorrhage pseudocyst. The patient was again monitored as no active bleeding was suspected; however the anemia worsened. A second EGD was performed and on this occasion red-brown discharge was detected emerging from the orifice of major duodenal papilla. At this point, a diagnosis of hemosuccus pancreaticus caused by pancreatic pseudocyst hemorrhage was made. The gastroduodenal artery was determined by CT angiography to be responsible for the bleeding, and arterial coil embolization was performed. The patient recovered well and no progressive anemia was seen after treatment.