# Hemosuccus Pancreaticus: A Rare Cause of Upper Gastrointestinal Bleeding in a Child With Recurrent Acute Pancreatitis and Splenic Artery Aneurysm

## TL;DR

This paper presents a rare case of upper gastrointestinal bleeding in a child with leukemia and pancreatitis caused by a splenic artery aneurysm.

## Contribution

The paper highlights the diagnostic and management challenges of hemosuccus pancreaticus in a pediatric patient with a complex medical history.

## Key findings

- Hemosuccus pancreaticus was identified as the cause of upper gastrointestinal bleeding in a child with recurrent pancreatitis.
- Angiography and embolization of the splenic artery aneurysm successfully controlled the bleeding.
- The case underscores the importance of considering rare causes of bleeding in patients with pancreatitis.

## Abstract

Hemosuccus pancreaticus is a rare cause of upper gastrointestinal bleeding, most commonly occurring in patients with acute or chronic pancreatitis. Other etiologies, such as pancreatic pseudocysts, pancreatic tumors, or iatrogenic injury from endoscopic ultrasound-guided fine needle aspiration (EUS-FNA), can also lead to wirsungorrhagia (bleeding from the ampulla of Vater), as described in hemosuccus pancreaticus.

We present the case of a child with acute lymphocytic leukemia who developed recurrent acute pancreatitis due to repeated treatment with Oncaspar, complicated by a pseudocyst and splenic artery aneurysm. His hospital course was further complicated by intermittent, massive upper gastrointestinal bleeding due to hemosuccus pancreaticus.

This case raises awareness and suspicion of hemosuccus pancreaticus, particularly in patients with acute or chronic pancreatitis. It also emphasizes the need for thorough investigation, given the rarity and diagnostic challenges of this condition. Additionally, we describe appropriate management through angiography and embolization of the splenic artery aneurysm, which successfully controlled the bleeding source.