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.
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Thus, endoscopy is usually not sufficient to make an initial precise diagnosis and a negative endoscopy does not exclude the possibility of hemksuccus pancreaticus. The owners of this website hereby guarantee to respect the legal confidentiality conditions, applicable in France, and not to disclose this data to third parties. Other clinical signs may be nausea, vomiting, icterus, and a palpable and pulsating epigastric mass.
Its magnitude varies from occult blood loss to massive life-threatening hemorrhage. The source of bleeding was not identified. Considering the influence of pancreatic enzymes, drug therapy seems feeble. Surgical procedures in our series included distal pancreatectomy and splenectomy, central pancreatectomy, intracystic ligation of the blood vessel, and aneurysmal ligation and bypass graft.
The most common cause is a pseudoaneurysm of the peripancreatic arteries due to acute bemosuccus chronic pancreatitis [ 12 ]. Access to the text HTML. Hemosuccus pancreaticus may be differentiated from hemorrhage due to pancreatic hekosuccus or stones eroding vessels in the wall of the GI tract. The purpose of this study was to analyze the diagnostic and therapeutic features of hemosuccus pancreaticus.
He was discharged in a hemodynamically stable condition and there was no further recurrence of GI bleeding hemosufcus 6 months of follow up. Hemosuccus pancreaticus Hemobilia Primary aortoenteric fistula Definition Bleeding from the pancreatic duct into duodenum via the ampulla of Vater.
Hemosuccus pancreaticus : a rare cause of gastrointestinal bleeding – EM|consulte
Hemosuccus pancreaticus associated with severe acute pancreatitis and pseudoaneurysms: Angiographic study could not localize the site of bleeding. Nevertheless, the source of bleeding is usually difficult to confirm, which will determine the cutting line of the pancreas.
Hemosuccus pancreaticus HP is a very rare and obscure cause of upper gastrointestinal bleeding. These enzymes exert an elastolytic action on the elastic component of the vessel walls and result in bleeding [ 3132 ].
Chang Gung Med J. Abdominal pain and hemorrhage usually with a recent history of instrumentation. Three weeks after discharge, she developed sudden onset of severe pancreqticus pain pancreatkcus passage of black tarry stool.
Hemosuccus pancreaticus – Wikipedia
These include hemobilia and primary aortoenteric fistula. Ann Chir ; CT abdomen showing chronic calcifying pancreatitis P, pancreas; C, calcification. A unique case of hematemesis in a year-old female. Ravi drafted the paper and revised it critically for important intellectual content.
Liver function test is normal apart from an increased serum bilirubin in the event of pancreaticobiliary reflux. Epigastric pain results from the elevation of pressure in the pancreatic ducts caused by blood clots [ 15 — 7 ].
Hemosuccus pancreaticus complicating chronic pancreatitis: Jeswanth and Professor P. Discussion Panvreaticus pancreaticus, defined as bleeding from the papilla of Vater via the pancreatic duct, is a rare and challenging cause of intermittent upper GI bleeding predominantly affecting men male: Gastrointestinal bleeding, which can be pancretaicus, hemetemesis or rarely hematochezia, usually follows in a day or two, relieving the pain.
Other hmeosuccus signs are more exceptional and hemoxuccus jaundice, vomiting, weight loss, and a palpable pulsating mass with a systolic thrill in the event of aneurysm [ 17 — 9 ]. Abdominal pain, gastrointestinal hemorrhage and hyperamylasemia should raise a high level of suspicion of hemosuccus pancreaticus as a possibility in the setting of history of chronic pancreatitis, pancreatic tumors and pancreatic vascular diseases. Hemosuccus pancreaticus hemosuccs, also known as pseudohematobilia or Wirsungorrhage is a rare cause of hemorrhage in the gastrointestinal tract.
Determining the cause of obscure bleeding in the gastrointestinal tract is the key in treating the disease. Pancreatoduodenectomy for hemosuccus pancreaticus in silent chronic pancreatitis. Serum amylase is normal outside episodes of acute pancreatitis. Serum amylase is normal outside episodes of acute pancreatitis. Accepted Feb Distal pancreatectomy with splenectomy was performed.
Successful treatment of bleeding pseudoaneurysms of chronic pancreatitis. Celiac trunk and superior mesenteric arteriography were performed transfemorally using a 4-F catheter. View at Google Scholar S. Hemosuccus pancreaticus is a rare cause of pancreatic bleeding, the prevalence being much lower than for segmentary portal hypertension or duodenal ulceration.
Surg Gynecol Obstet ; Liver function test is normal apart from an increased serum bilirubin in the event of pancreaticobiliary reflux. It stimulates thrombus formation in the pseudoaneurysm. Selective embolization can be performed before surgery to favor hemodynamic control [ 1 Click here to see the Library15 Click here to see the Library et 19 Click here to see the Library ].
The treatment technique included a superselective catheterization of the feeding artery, followed by endosaccular treatment of the pseudoaneurysm. Abdominal pain, gastrointestinal hemorrhage and hyperamylasemia.
Finally, pancreaticjs pancreaticus can occur as a complication of endoscopic retrograde cholangiopancreatography. We believe that hemoosuccus is safe and plays an important role, particularly where expertise for interventional radiology is lacking, as in our case. Gastrointestinal hemorrhage through the pancreatic duct.
Hemosuccus pancreaticus bleeding from the pancreatic duct into the gastrointestinal tract via the ampulla of Vater is a rare, potentially life-threatening and obscure cause of upper gastrointestinal bleeding.
Contrast-enhanced CT scan of the abdomen reveals dilated pancreatic duct possibly filled with blood.