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Haemosuccus pancreatitis: A rare cause of GI bleed, diagnosis on CT Angiography – Case series & review of literature

Haemosuccus pancreatitis also known as Pseudohaemobilia or haemoductal pancreatitis, is defined as upper gastrointestinal hemorrhage originating from the pancreatic duct into the duodenum via the Ampulla of Vater, or major pancreatic papilla. A triad of epigastric pain, intermittent gastro intestinal bleeding and hyperamylasemia [1,2]. We present three cases of chronic pancreatitis presenting as upper GI bleed and with epigastric pain and sudden drop in Hematocrit. One had bleed from pseudo aneurysm arising from hepatic artery leaking into pseudo cyst, second had erosion of wall of splenic vein leaking into pancreatic duct through small pseudocyst and the third patient was post cystojejunostomy with who bled into cyst, probably from a vessel in wall of cyst, well demonstrated on venous phase of CT angiography and later responded to conservative management. Hemorrhage from the pancreatic duct, i.e. Haemosuccus Pancreaticus (HP), is a rare cause of gastrointestinal bleeding. Pancreatic Homosuccus is usually due to the rupture of an aneurysm of a visceral artery, most likely the splenic artery, in chronic pancreatitis. Other causes of HP are rare. Keywords: haemosuccus pancreaticus; pseudo aneurysm; pancreatitic pseudocyst; upper gastrointestinal bleeding; embolization.