Embolisation of branches of the superior mesenteric artery in the treatment of haemosuccus pancreaticus

Haemosuccus pancreaticus (HP) is an uncommon cause of upper gastrointestinal (GI) bleeding, most often intermittent, making it difficult to diagnose, becoming fatal. It usually occurs in patients with chronic pancreatitis and is caused by the rupture of a visceral aneurysm within the main pancreatic...

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Veröffentlicht in:BMJ case reports 2019-05, Vol.12 (5), p.e229110
Hauptverfasser: Raymundo, Selma Regina de Oliveira, da Silva, Gabriela Leopoldino, Reis, Luiz Fernando, Freire, Antonio Fernandes
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Sprache:eng
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Zusammenfassung:Haemosuccus pancreaticus (HP) is an uncommon cause of upper gastrointestinal (GI) bleeding, most often intermittent, making it difficult to diagnose, becoming fatal. It usually occurs in patients with chronic pancreatitis and is caused by the rupture of a visceral aneurysm within the main pancreatic duct. The association between pseudoaneurysm formation and pancreatitis is well established. Pseudoaneurysm occurs in 3.5%–10% of pancreatitis cases and its rupture is a rare but life-threatening complication of chronic pancreatitis occurring in 6%–8% of patients with pseudocysts and corresponds to less than 1% of cases of GI bleeding.Its diagnosis is challenging, given the intermittent nature of bleeding. Angiographic therapy is considered the first-choice treatment, especially in patients who are stable haemodynamically. We present a case of embolisation of inferior pancreaticoduodenal branches with polyvinyl alcohol microparticles in the treatment of HP.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2018-229110