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KMID : 0882420160900050421
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Korean Journal of Medicine
2016 Volume.90 No. 5 p.421 ~ p.426
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Recurrent Upper Gastrointestinal Hemorrhage due to Hemosuccus Pancreaticus from True Splenic Artery Aneurysm
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유은수:Yoo Eun-Soo
유병무:Yoo Byung-Moo/유은정:Yoo Eun-Jung/윤소영:Yoon So-Young/양민재:Yang Min-Jae/황재철:Hwang Jae-Chul/김진홍:Kim Jin-Hong
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Abstract
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Hemosuccus pancreaticus, defined as bleeding from the papilla of Vater via the pancreatic duct, is a rare cause of recurrent upper gastrointestinal bleeding. We report the case of a 67?year?old man with recurrent gastrointestinal bleeding, who was subsequently diagnosed with hemosuccus pancreaticus caused by rupture of a true splenic artery aneurysm. The patient had chronic pancreatitis after considerable delay and unnecessary surgical small bowel exploration. The patient was cured with distal pancreatectomy because concomitant arcuate ligament syndrome precluded the angiographic approach via the celiac trunk, and tortuous dilatation of the distal pancreatic duct could not exclude the main duct type of intraductal papillary mucinous neoplasm (IPMN). In the surgical specimen, the pancreatic duct contained a hematoma and was lined by normal epithelium, indicating rupture of the splenic artery aneurysm that bled into the pancreatic duct.
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KEYWORD
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Chronic pancreatitis, Gastrointestinal hemorrhage, Splenic artery aneurysm
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