Nasr Dayana, Bhutta Abdul, Kudaravalli Pujitha, Ionno Alyssa, Aswath Ganesh
Internal Medicine, State University of New York (SUNY) Upstate University Medical Hospital, Syracuse, USA.
Gastroenterology, State University of New York (SUNY) Upstate University Medical Hospital, Syracuse, USA.
Cureus. 2022 Jun 15;14(6):e25970. doi: 10.7759/cureus.25970. eCollection 2022 Jun.
Hemosuccus pancreaticus is a rare cause of gastrointestinal bleeding that usually presents with melena and abdominal pain. It is defined as a hemorrhage from the ampulla of Vater passing through the main pancreatic duct toward the second portion of the duodenum. Imaging is usually required to establish a diagnosis, and angiography continues to be the gold standard for both treatment and diagnosis. In some instances where bleeding is uncontrolled or if the patient is unstable, surgery may be required. Physicians should have a high index of suspicion, especially in patients with a history of chronic pancreatitis, as this diagnosis is associated with a very high mortality rate if left untreated. We report a case of a 67-year-old male with a known history of chronic pancreatitis and pancreatic pseudocyst who presented with melena and right upper quadrant abdominal pain and was found to have hemosuccus pancreaticus secondary to a gastroduodenal artery bleed. He underwent successful angiographic embolization and was discharged home after ensuring resolution of bleed and improvement in symptoms.
胰源性消化道出血是胃肠道出血的一种罕见原因，通常表现为黑便和腹痛。它被定义为来自 Vater 壶腹的出血，经主胰管流向十二指肠第二部。通常需要影像学检查来确诊，血管造影仍是治疗和诊断的金标准。在某些出血无法控制或患者病情不稳定的情况下，可能需要进行手术。医生应保持高度警惕，尤其是对于有慢性胰腺炎病史的患者，因为如果不治疗，这种诊断的死亡率非常高。我们报告一例 67 岁男性，有慢性胰腺炎和胰腺假性囊肿病史，出现黑便和右上腹疼痛，经检查发现是由胃十二指肠动脉出血继发的胰源性消化道出血。他接受了成功的血管造影栓塞治疗，在确保出血停止且症状改善后出院回家。
