Korean J Med.  2005 Apr;68(4):436-440.

A case of hemosuccus pancreaticus in arteriovenous malformation

Affiliations
  • 1Department of Internal Medicine, Pusan National University College of Medicine, Busan, Korea. gasong@pusan.ac.kr

Abstract

Hemosuccus pancreaticus describes the syndrome of gastrointestinal bleeding into the pancreatic duct, manifested by blood loss through the ampulla of Vater. Pancreatic arteriovenous malformation (AVM), while extremely rare, are frequently complicated by gastrointestinal bleeding. Endoscopy is essential to rule out other causes of upper gastrointestinal bleeding. In rare cases, active bleeding is seen from the duodenal ampulla. Selective celiac angiography is the only diagnostic test. Angiography is always necessary to facilitate tactics of treatment, even if diagnosis has been established by non-invasive imaging modalities. To obtain complete regression, total extirpation of the affected organ, or at least the involved portion, should be performed before this disease leads to the lethal complications of gastrointestinal bleeding and portal hypertension. Transcatheter arterial embolization is the only alternative treatment for the control of hemorrhage. We experienced a patient with upper gastrointestinal bleeding in which the diagnosis of hemosuccus pancreaticus secondary to a AVM in chronic pancreatitis was diagnosed preoperatively. We report our experience with a review of literatures.

Keyword

Hemosuccus pancreaticus (HP); Arteriovenous malformation (AVM)

MeSH Terms

Ampulla of Vater
Angiography
Arteriovenous Malformations*
Diagnosis
Diagnostic Tests, Routine
Endoscopy
Hemorrhage
Humans
Hypertension, Portal
Pancreatic Ducts
Pancreatitis, Chronic
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