Elusive Gastrointestinal Bleeding: A Rare Case of Venous Hemosuccus Pancreaticus

TL;DR

A rare case of venous bleeding from the pancreas, caused by cancer, is described in a 68-year-old man.

Contribution

Presentation of a rare case of venous hemosuccus pancreaticus caused by pancreatic adenocarcinoma.

Findings

Bleeding originated from the ampulla of Vater and was determined to be venous in nature.

The case was secondary to newly diagnosed pancreatic adenocarcinoma, not chronic pancreatitis.

Management included CT angiography and embolization of the bleeding vessel.

Abstract

Hemosuccus pancreaticus is a rare but potentially life-threatening cause of intermittent upper gastrointestinal bleeding, characterized by hemorrhage from the pancreatic duct into the duodenum. Most cases are secondary to chronic pancreatitis and rupture of visceral artery pseudoaneurysms, particularly the splenic artery. Management typically involves CT angiography with embolization of the bleeding vessel. We describe the case of a 68-year-old male found to have spontaneous bleeding from the ampulla of Vater, later determined to be of venous origin secondary to newly diagnosed pancreatic adenocarcinoma.

Figures