Peutz--Jeghers /or portal hypertensive Syndrome) enteropathy Hemosuccus pancreaticus
It is worth mentioning here, although not classified as hemobilia, that hemosuccus pancreaticus
(also referred to as Wirsungorrhagia) can occur via pathophysiologically similar mechanisms, for example, pancreatitis eroding into the splenic artery and causing bleeding into the main pancreatic duct [30, 31].
Hemosuccus pancreaticus is an especially rare cause of gastrointestinal bleeding.
The diagnosis of hemosuccus pancreaticus is based on clinical exam and past medical history of pancreatitis.
It has been proposed that hemosuccus pancreaticus secondary to a hemorrhagic pancreatic pseudoaneurysm should be suspected in any patient with pancreatitis and persistent or increased abdominal pain in the setting of gastrointestinal bleeding, hemodynamic instability, or a drop in hematocrit [1-3, 5].
We believe operative therapy is necessary for hemosuccus pancreaticus secondary to bleeding IPDA pseudoaneurysms (or any bleeding peripancreatic pseudoaneurysms for that matter) not responsive to initial embolization or in the setting of hemodynamic instability.
Haemorrhage into the pancreatic duct (Hemosuccus pancreaticus
): recognition and management.
In addition, bleeding into the pancreatic duct manifesting as recurrent episodes of hemosuccus pancreaticus
have been reported as well as bleeding into the common bile duct.
Hemosuccus pancreaticus from a pseudoaneurysm of the hepatic artery proper in a patient with a pancreatic pseudocyst.
Hemosuccus pancreaticus due to a pressure ulcer in pancreatolithiasis.
Two cases of hemosuccus pancreaticus in which hemostasis was achieved by transcatheter arterial embolization.
(6) Unusual complications have been described secondary to left gastric pseudoaneurysms, including hemosuccus pancreaticus
(hemoductal pancreatitis) and wirsungorrhagia (direct pseudoaneurysm rupture into the duct of Wirsung).