Hemosuccus Pancreaticus as a Rare Cause of Gastrointestinal Bleeding: a Report of Two Cases


Pancreatic diseases are known to be associated with complications such as pseudocyst and abscess. A pseudoaneurysm associated with pancreatitis may develop as well. The pseudoaneurysm may rupture into various parts of the gastrointestinal tract; the peritoneal cavity, or the retroperitoneum. We report two cases of Hemosuccus pancreaticus admitted to our center in the past five years. One case was associated with acute pancreatitis, and another case was associated with chronic pancreatitis. A pseudocyst was found in two cases. Both were successfully managed by emergency surgery. So, Hemosuccus pancreaticus is a rare cause of gastrointestinal bleeding with difficult diagnosis, and surgery is the effective treatment for the patient with severe bleeding. However in cases with no life-threatening bleeding angiography and embolization can be performed.

Spivak H, Galloway JR, Amerson JR, et al. Management of Pancreatic Pseudocysts. J Am Coll Surg 1998;186:507-11.

Igari K, Ochiai T, Aihara A, et al. Hemosuccus pancreaticus caused by a primary splenic artery aneurysm as a rare cause of gastrointestinal bleeding: report of a case. Int Surg 2010;95(4):325-8.

Tsutsumi Y, Kunieda Y, Yamauchi J, et al. A case of hemosuccus pancreaticus caused by rupture of an aneurysm of the splenic artery. Nihon Shokakibyo Gakkai Zasshi 2013;110(7):1296-303.

Garcea G, Krebs M, Lloyd T, et al. Haemorrhage from Pancreatic Pseudocysts Presenting as Upper Gastrointestinal Haemorrhage. Asian J Surg 2004;27(2):137-40.

Khalid A, Brugge W. ACG practice guidelines for the diagnosis and management of neoplastic pancreatic cysts. Am J Gastroenterol 2007;102(10):2339-49.

Pinarba┼či B, Poturo─člu S, Yanar H, et al. A rare cause of hemosuccus pancreaticus: primary splenic artery aneurysm ruptured into pancreatic serous cystadenoma. Turk J Gastroentero 2008;19(1):57-63.

Grisendi A, Lonardo A, Della Casa G, et al. Hemoductalpancreatitis secondary to gastroduodenal artery-rupturedpseudoaneurysm: a rare cause of hematemesis. Am J Gastroenterol 1991;86(11):1654-7.

Maeda A, Kunou T, Saeki S, et al. Pseudoaneurysm of the cystic artery with hemobilia treated by arterial embolization and elective cholecystectomy. J Hepatobiliary Pancreat Surg 2002;9(6):755-8.

Chiu HH, Chen CM, Wang KCh, et al. Pancreatic pseudocyst bleeding associated with massive intraperitoneal hemorrhage. Am J Surg 2006;192(1):87-8.

Ray S, Das K, Ray S, et al. Hemosuccus pancreaticus associated with severe acute pancreatitis and pseudoaneurysms: a report of two cases. JOP 2011;12(5):469-72.

Han B, Song ZF, Sun B. Hemosuccus pancreaticus: a rare cause of gastrointestinal bleeding. Hepatobiliary Pancreat Dis Int 2012;11(5):479-88.

Okuno A, Miyazaki M, Ito H, et al. Nonsurgical management of ruptured pseudoaneurysm in patients with hepatobiliary pancreatic diseases, 2001. Am J Gastroenterol 2001;96(4):1067-71.

Grace PA, Williamson RC. Modern management of pancreatic pseudocysts. Br J Surg 1993;80(5):573-81.

Warshaw AL. Pancreatic cysts and pseudocysts: new rules for a new game. Br J Surg 1989;76(6):533-4.

Mullins RJ, Malagoni MA, Bergamini TM, et al. Controversies in the management of pancreatic pseudocysts. Am J Surg 1998;155(1):165-72.

Baron TH, Morgan DE. The diagnosis and management of fluid collections associated with pancreatitis. Am J Med 1997;102(6):555-63.

Rantala A, Ovaska J. Major hemorrhage associated with a pseudocyst in chronic pancreatitis: a gastro-surgical challenge. Ann Chir Gynaecol 1996;85(3):217-21.

Somani PO, Jain SS, Shah DK, et al. Uncomplicated spontaneous ruptures of pancreatic pseudocyst into stomach: A case report. World J Gastrointest Endosc 2013;5(9):461-4.

IssueVol 53, No 5 (2015) QRcode
Hemobilia Hemosuccus pancreaticus Pancreatic Ducts Hemorrhage

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How to Cite
Maddah G, Abdollahi A, Golmohammadzadeh H, Abdollahi M. Hemosuccus Pancreaticus as a Rare Cause of Gastrointestinal Bleeding: a Report of Two Cases. Acta Med Iran. 1;53(5):320-323.