Korean J Gastrointest Endosc.  2009 Dec;39(6):389-392.

A Case of Hemosuccus Pancreaticus Mistaken for Hemobilia

• Lee SH
• Koh DH
• Park SW
• Kim JY
• Kim YW
• Jang HJ
• Kae SH
• Lee J

Abstract

Hemosuccus pancreaticus is a rare cause of chronic and intermittent chronic gastrointestinal hemorrhage, and this condition cannot be easily detected by endoscopy. We report here on a 51-year-old woman with obstructive jaundice and a history of acute pancreatitis and chronic alcoholism. Abdominal computed tomography showed a dilated distal common bile duct. We performed endoscopic retrograde cholangiopancreatography to decompress the bile duct and we found a blood clot on the orifice of the ampulla of Vater. Hemobilia with massive bleeding was seen during the examination. Angiography for controlling the hemorrhage showed the pseudoaneurysm of the pancreaticoduodenal artery. Angiographic embolization was successful for controlling the arterial hemorrhage. The patient remained symptom-free and he was discharged without complications.

Keyword

Hemosuccus pancreaticus; Chronic pancreatitis; Pseudoaneurysm; Jaundice; Hemobilia

MeSH Terms

Alcoholism
Ampulla of Vater
Aneurysm, False
Angiography
Arteries
Bile Ducts
Cholangiopancreatography, Endoscopic Retrograde
Common Bile Duct
Endoscopy
Female
Gastrointestinal Hemorrhage
Hemobilia
Hemorrhage
Humans
Jaundice
Jaundice, Obstructive
Middle Aged
Pancreatitis
Pancreatitis, Chronic