Hemosuccus Pancreaticus: A Rare Bleeding Pseudoaneurysm of the Inferior Pancreaticoduodenal Artery Treated with Embolization

Abstract

Hemosuccus pancreaticus is a very rare cause of gastrointestinal bleeding and can be life-threatening if not managed appropriately. Still thought to be a surgical problem, advances in medical therapy now afford these patients the opportunity to undergo less-invasive angiography techniques to manage this illness when it occurs. Here, we present a case of hemosuccus pancreaticus safely managed with liquid N-butyl-2-cyanoacrylate embolization.

Figure 1

CT showing pancreas with necrotic fluid collections on axial (a) and coronal (b) sections. Contrast extravasation into the IPDA pseudoaneurysm (red arrows) on axial (c) and coronal (d) sections. Yellow arrowheads point to pancreatic duct stent. Blue arrowheads point to pancreatic fluid collections.

Figure 2

Angiography. (a) Superior mesenteric arteriogram showing pseudoaneurysm at the IPDA (red arrow). (b) Selective catheterization of the IPDA showing active extravasation into the pancreatic duct from the IPDA pseudoaneurysm (red arrow).