2017 Volume 90 Issue 1 Pages 66-69
A 74-year-old man was admitted due to the persistent blood per rectum and dizziness. Emergency upper endoscopy showed no sign of hemorrhage in stomach but a string of coagulated blood attached to the papilla of Vater was noticed. Intermittent flow of blood along with yellow and translucent bile was observed. The enhanced abdominal computed tomography was unable to detect active bleeding in gastrointestinal tract, but showed atrophy and multiple calcification of pancreas with a gastroduodenal artery aneurysm suggesting the previous condition of chronic pancreatitis which is one of the main causes of HP. He was successfully treated with angiography and transcatheter embolization of the aneurysm and his hemoglobin stabilized without requiring further treatment. HP is a rare cause of gastrointestinal bleeding associated with pancreatitis. While rarity of the condition and elusive bleeding pattern pose a challenge to an experienced gastroenterologist, HP should be considered in a case of occult bleeding with a history or an evidence of preceding pancreatitis.
