Hemosuccus pancreaticus caused by gastroduodenal artery pseudoaneurysm associated with chronic pancreatitis: A case report and review of literature

• 作者: Cheng-Hang Jiang Hai-Yu Cui Jie Dong Yang Wen You-Wei Chen
• 来源期刊: 世界临床病例杂志
• 学科: 医学
• 关键词: Hemosuccus pancreaticus Chronic pancreatitis Gastroduodenal artery pseudoaneurysm Upper gastrointestinal bleeding Angiographic embolization Case report
• 年，卷（期）: 2021,（1）
• 页码范围: 236-244
• 页数: 9页
• 分类号: R57

摘要

BACKGROUND Hemosuccus pancreaticus is a very rare but severe form of upper gastrointestinal hemorrhage.The most common etiology is peripancreatic pseudoaneurysm secondary to chronic pancreatitis.Due to the rarity of gastroduodenal artery pseudoaneurysms,most of the current literature consists of case reports.Limited knowledge about the disease causes diagnostic difficulty.CASE SUMMARY A 39-year-old man with a previous history of chronic pancreatitis was hospitalized due to hematemesis and melena for 2 wk,with a new episode lasting 1 d.Two weeks prior,the patient had visited a local hospital for repeated hematemesis and melena.Esophagogastroduodenoscopy indicated hemorrhage in the descending duodenum.The patient was discharged after the bleeding stopped,but hematemesis and hematochezia recurred.Bedside esophagogastroduodenoscopy showed no obvious bleeding lesion.On admission to our hospital,he had hematemesis,hematochezia,left middle and upper abdominal pain,severe anemia,and elevated blood amylase.After admission,intermittent hematochezia was observed.Abdominal contrast-enhanced computed tomography revealed a pseudoaneurysm in the pancreas head.Angiography confirmed the diagnosis of gastroduodenal artery pseudoaneurysm.The pseudoaneurysm was successfully embolized with a coil and cyanoacrylate.No bleeding was observed after the operation.After discharge from the hospital,a telephone follow-up showed no further bleeding signs.CONCLUSION Hemosuccus pancreaticus caused by gastroduodenal artery pseudoaneurysm associated with chronic pancreatitis is very rare.This diagnosis should be considered when upper gastrointestinal bleeding and abdominal pain are intermittent.Abdominal enhanced computed tomography and angiography are important for diagnosis and treatment.