Hemosuccus pancreaticus as an unusual cause of upper gastrointestinal bleeding: Case report and literature review

Daniela Ayala, Juliana González T, Felipe Pedroza, Carlos Eduardo Rey Chaves, Danny Conde, Juan Carlos Sabogal Olarte

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


BACKGROUND: Hemosuccus pancreaticus is a rare cause of upper gastrointestinal bleeding (1/1500) and represents the loss of blood through the main pancreatic duct and its exteriorization through the major duodenal papilla. It can lead to massive bleeding, which is potentially life-threatening. This condition most commonly follows pseudoaneurysm formation due to acute or chronic pancreatitis. As a result of its infrequency, it is difficult to diagnose, and the mortality rate remains high. To our knowledge, this is the first case report on the Latin-American population.

CASE PRESENTATION: A 70-year-old male patient presented with diffuse severe abdominal pain associated with melaena. Angiotomography was performed, ruling out mesenteric ischemia, with evidence of pancreatic head tumor with liver metastases. Sandblom's triad was present and the diagnosis of hemosuccus pancreaticus was confirmed. Multiple arteriograms were performed, with pseudoaneurysm of gastroduodenal artery findings. Therefore, endovascular coil embolization was performed in two opportunities to control the bleeding.

CONCLUSION: Upper gastrointestinal bleeding is a clinical challenge for the surgeon and emergency medicine. It's a complex entity with high mortality that should be suspected in patients with acute or chronic pancreatitis and periampullary tumors with non-established sources of bleeding. Clinically manifested by Sandblom's triad. Its diagnosis gold standard is arteriography plus embolization which is also therapeutic. Surgery is related to higher mortality and reserved for specific situations.

Original languageEnglish
Article number107624
Pages (from-to)107624
JournalInternational Journal of Surgery Case Reports
StatePublished - Oct 2022


  • Angiographic embolization
  • Hemoductal pancreatitis
  • Hemosuccus pancreaticus
  • Pseudohemobilia
  • Upper gastrointestinal bleeding
  • Wirsungrhagia


Dive into the research topics of 'Hemosuccus pancreaticus as an unusual cause of upper gastrointestinal bleeding: Case report and literature review'. Together they form a unique fingerprint.

Cite this