Hemosuccus pancreaticus, also known as pseudohematobilia or Wirsungorrhage is a rare cause of hemorrhage in the gastrointestinal tract. It is caused by a. Methods: We reviewed our experience with management of 17 patients admitted to surgery or gastroenterology units for hemosuccus pancreaticus between. Hemosuccus pancreaticus (HP) is a rare and potentially life threatening clinical entity and is described as bleeding from the ampulla of Vater.
|Published (Last):||25 June 2016|
|PDF File Size:||3.69 Mb|
|ePub File Size:||13.94 Mb|
|Price:||Free* [*Free Regsitration Required]|
Kumar contributed to conception and design, acquisition, analysis, and interpretation of data. Hemosucfus some rare cases, aneurysms may not be present; however, pathological or iconographic examinations show findings suggestive of vascular malformations [ 20 ].
Crescendo-decrescendo abdominal pain followed by hemorrhage with a repeat cycle of pain followed by hemorrhage.
Ultimately, angiography remains the gold standard for diagnosis and therapy. Initial laboratory studies revealed hemoglobin of 4. Ravichandran gave the final approval of the version to be published. We found that the pseudocyst was full of blood clots and there was a blister-like area in the wall of the cyst Figure 4. Chronic calcifying pancreatitis, GI bleeding, hemosuccus pancreaticus. Classic triad Abdominal pain, gastrointestinal hemorrhage and hyperamylasemia.
It is also indicated in patients who have other indications for operative intervention pseudocyst, pancreatic abscess, gastric outlet obstruction, obstructive jaundice, or incapacitating pain and are otherwise appropriate surgical candidates [ 27 ]. Blood tests usually do not reveal significant findings, and liver function test results are usually normal apart from an increased serum bilirubin level in the events of pancreaticobiliary reflux.
Conclusion Timely intervention, either by embolization or by surgery, can control this potentially life-threatening bleeding. The balloon can be deflated and left in place for secondary use if needed. Visceral angiography is the most sensitive diagnostic technique for a visceral artery aneurysm or pseudoaneurysm. It also demonstrated a dilated pancreatic duct Fig. Hemosuccus pancreaticus has been estimated to occur in about one in 1, cases of gastrointestinal bleeding [ 6 ].
He responded initially but fever recurred on the 7th day after admission. After initial resuscitation, it was decided to perform an emergent contrast-enhanced computed tomography CT of the abdomen in lieu of a diagnostic endoscopy because of the high serum lipase. The sample included forty-three men and eight women. Hemosuccus pancreaticus after endoscopic ultrasound-guided fine needle aspiration of a pancreatic cyst.
Contrast-enhanced CT scan of the abdomen reveals dilated pancreatic duct possibly filled with blood.
Hemosuccus pancreaticus: A mini-review
Pancreatoduodenectomy for hemosuccus pancreaticus in silent chronic pancreatitis. Mean age was 32 hemosuccux 11—55 years. The anatomical position might affect the prognosis.
CT abdomen showing chronic calcifying pancreatitis P, pancreas; C, calcification. A year-old male with a history of chronic alcoholism having a 3-week history of alcohol-related severe acute pancreatitis was referred to our institution for a necrosectomy.
Support Center Support Center. Bleeding from the duct of Santorini can be caused by pancreas divisuma possible congenital cause of pancreatitis.
Hemosuccus pancreaticus: A mini-review
The remaining patients had normal UGI endoscopic findings. It was decided to perform a contrast-enhanced computed tomography CT scan that demonstrated a hemorrhagic pancreatic pseudocyst with possible active bleeding into the cyst.
This potentially life-threatening complication of pancreatitis may pose a significant diagnostic and therapeutic dilemma, especially in patients who do not exhibit symptoms such as abdominal pain, jaundice, or GI bleeding. Published online Mar The cause is a transient increase in intraductal pressure by a blood clot.
Pseudoaneurysm of the hepatic, gastroduodenal, or pancreaticoduodenal artery has also been reported. During an episode of acute pancreatitis, hemosuccus pancreaticus can occur after necrosis of an arterial wall duodenopancratic arcade, gastroduodenal artery, splenic artery.
All operated patients had a clinical examination after 1 month and were kept on routine followup. Abdominal pain, gastrointestinal hemorrhage and jaundice.
This compares favorably with the mortality rate of our series 7. Contrast-enhanced computed tomography of the abdomen showed a large pseudocyst with extravasation of contrast within the cyst Figures 2 and 3. Surgical treatment For patients with hemodynamic instability, emergency operations are inevitable.
Failure of catheter embolization may result from factors such ehmosuccus inability to isolate the bleeding vessel, spasm of the bleeding vessel, incomplete arterial occlusion, or misidentification of the bleeding vessel [ 212526 ].