| [ Summary ] |
Gastrointestinal hemorrhaging associated with hemosuccus pancreaticus is a rare condition that poses a significant diagnostic and therapeutic challenge. It is thought to occur most commonly in conditions of acute or chronic pancreatitis with ruptures of pseudo-aneurysms of the spleen or the hepatic artery into the pancreatic duct. Abdominal ultrasound and CT ecanning can noninvasively define pancreatic pseudocysts and pseudoaneurysms. Real-time ultrasonography may document bleeding from pulsatile pseudoaneurysm. Selective celiac angiography, however, is the only reliable diagnostic test that can definitively outline a pseudoaneurysm and demonstrate its rupture into a pseudocyst or into the pancreatic duct. Pancreatic resection including excision of the pseudoaneurysm and pseudocyst is the treatment of choice. In cases where resection is not possible, Iigation or resection of the artery proximal and distal to the pseudoaneurysm and drainage of the pseudocyst into the gastrointestinal tract is an acceptable alternative procedure and intraarterial catheter embolization of the bleeding vessel can be a lifesaving procedure in these severe cases. Hemosuccus pancreaticus should be taken inta consideration as a significant condition associated with pancreatitis in daily practice. |