Hemosuccus pancreaticus – rare complication of chronic pancreatitis

Česká verzia

Authors: Igor Šturdík ¹; Martin Kužma ¹; Zuzana Kužmová ¹; Tomáš Koller ¹; Vladimír Javorka ²; Tibor Hlavatý ¹; Juraj Payer ¹
Authors place of work: V. interná klinika LF UK a UN Bratislava, Nemocnica Ružinov, Slovenská republika ¹; I. rádiologická klinika LF UK a UN Bratislava, Nemocnica Staré Mesto a Slovenská zdravotnícka univerzita Bratislava, Slovenská republika ²
Published in the journal: Vnitř Lék 2016; 62(10): 833-836
Category: Case Reports

Summary

Hemosuccus pancreaticus is a rare cause of upper digestive tract bleeding, it is hemorrhage to the pancreatic duct. A case report is about 56-years old man who was repeatedly hospitalized and suffered from melena and enterorrhagia during 3 years. Imaging studies did not clearly identified etiology of bleeding or source of hemorrhage was wrong identified. Finally, hemosuccus pancreaticus from collaterals of pseudoaneurysm after embolization was suspected because of repeating hemorrhage and embolization of a gastroduodenal artery in history. The interventional procedure was made in a the proximal part of the gastroduodenal artery with a good clinical response. This disease causes severe diagnostic and therapeutic problems, the unrecognized one can be fatal.

Key words:
enterorrhagia – hemosuccus pancreaticus – chronic pancreatitis – melena

Zdroje

1. Novotný I, Boudný J, Kala Z. Hemosuccus pancreaticus jako komplikace akutní exacerbace chronické pankreatitidy. Česká a slovenská gastroenterologie a hepatologie 2004; 58(1): 16–20.

2. Janík V, Pádr R, Keil R et al. Léčba hemosuccus pancreaticus embolizací obou gastrických tepen. Cas Lek Cesk 2008; 147(10): 538–541.

3. Koren M, Kinova S, Bedeova J et al. Hemosuccus pancreaticus. Bratisl Lek Listy 2008; 109(1): 37–41.

4. Sugiki T, Hatori T, Imaizumi T et al. Two cases of hemosuccus pancreaticus in which hemostasis was achieved by transcatheter arterial embolization. J Hepatobiliary Pancreat Surg 2003; 10(6): 450–454.

5. Vimalraj V, Kannan DG, Sukumar R et al. Haemosuccus pancreaticus: diagnostic and therapeutic challenges. HPB (Oxford) 2009; 11(4): 345–350. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1477–2574.2009.00063.x>.

6. Suter M, Doenz F, Chapuis G et al. Haemorrhage into the pancreatic duct (Hemosuccus pancreaticus): recognition and management. Eur J Surg 1995; 161(12): 887–892.

7. Risti B, Marincek B, Jost R et al. Hemosuccus pancreaticus as a source of obscure upper gastrointestinal bleeding: three cases and literature review. Am J Gastroenterol 1995; 90(10): 1878–80.

8. Julianov A, Rachkov I, Karashmalakov A. Hemosuccus pancreaticus. Surgery 2003; 133(1): 114–115.

9. Koizumi J, Inoue S, Yonekawa H et al. Hemosuccus pancreaticus: diagnosis with CT and MRI and treatment with transcatheter embolization. Abdom Imaging 2002; 27(1): 77–81.

10. Benz CA, Jakob P, Jakobs R et al. Hemosuccus pancreaticus – a rare cause of gastrointestinal bleeding: diagnosis and interventional radiological therapy. Endoscopy 2000; 32(5): 428–431.

11. Bohl JL, Dossett LA, Grau AM. Gastroduodenal artery pseudoaneurysm associated with hemosuccus pancreaticus and obstructive jaundice. J Gastrointest Surg 2007; 11(12): 1752–1754.

12. Bergert H, Hinterseher I, Kersting S et al. Management and outcome of hemorrhage due to arterial pseudoaneurysms in pancreatitis. Surgery 2005; 137(3): 323–328.

13. Kapoor S, Rao P, Pal S et al. Hemosuccus pancreaticus: an uncommon cause of gastrointestinal hemorrhage. A case report. JOP 2004; 5(5): 373–376.

14. Akpinar H, Dicle O, Ellidokuz E et al. Hemosuccus pancreaticus treated by transvascular selective arterial embolization. Endoscopy 1999; 31(2): 213–214.

15. Gambiez LP, Ernst OJ, Merlier OA et al. Arterial embolization for bleeding pseudocysts complicating chronic pancreatitis. Archives of surgery 1997; 132(9): 1016–1021.

16. Boudghene F, L‘Hermine C, Bigot JM. Arterial complications of pancreatitis: diagnostic and therapeutic aspects in 104 cases. J Vasc Interv Radiol 1993; 4(4): 551–558.

17. de Perrot M, Berney T, Buhler L et al. Management of bleeding pseudoaneurysms in patients with pancreatitis. Br J Surg 1999; 86(1): 29–32.

18. Lermite E, Regenet N, Tuech JJ et al. Diagnosis and treatment of hemosuccus pancreaticus: development of endovascular management. Pancreas 2007; 34(2): 229–232.

19. Bender JS, Bouwman DL, Levison MA et al. Pseudocysts and pseudoaneurysms: surgical strategy. Pancreas 1995; 10(2): 143–147.

20. Rammohan A, Palaniappan R, Ramaswami S et al. Hemosuccus Pancreaticus: 15-Year Experience from a Tertiary Care GI Bleed Centre. ISRN Radiol 2013; 2013: 191794. Dostupné z DOI: <http://dx.doi.org/10.5402/2013/191794>.

21. Sul HR, Lee HW, Kim JW et al. Endovascular management of hemosuccus pancreaticus, a rare case report of gastrointestinal bleeding. BMC Gastroenterology 2016; 16:5. Dostupné z DOI: <http://dx.doi.org/10.1186/s12876–016–0418–3>.