A Case of Chronic Pancreatitis with Hemosuccus Pancreaticus and Left-Sided Portal Hypertension

Hiroshi Iino, Tatsuya Shirasu, Kazuhiro Karikome, Kaoru Nagahori, Hideki Fujii, Takayoshi Sekikawa, Yoshiro Matsumoto, Hideyuki Hagiwara*

The First Department of Surgery and *The First Department of Pathology, Yamanashi Medical College

An extremely rare case of chronic pancreatitis with hemosuccus pancreaticus and left-sided portalhypertension is reported. A 45-year-old man was medicated for chronic pancreatitis and gastroduodenal ulcer. He was admitted to our institute because of massive duodenal bleeding and underwent emergent distal gastrectomy. After discharge, he had epigastric pain and was admitted again under a diagnosis of chronic pancreatitis and pancreatic pseudocyst. His blood count showed pancytopenia. Abdominal CT revealed splenomegaly and a low density mass in the pancreatic tail. Angiogram revealed aneurysmal change of the distal splenic artery, and stenosis of the splenic vein and collateral circulation on the venous phase. Distal pancreatectomy with splenectomy was performed. On the resected specimen, there was a pseudocyst filled with blood clot in the pancreatic tial, and it communicated with the main pancreatic duct. In addition, the splenic artery had ruptured into the pseudocyst. The stenosis of the splenic vein was due to fibrosis of the surrounding tissue.

Key words
chronic pancreatitis, hemosuccus pancreaticus, left-sided portal hypertension

Reprint requests
Hiroshi Iino The First Department of Surgery, Yamanashi Medical College
1110 Shimokato Tamahomachi, Nakakomagun, Yamanashi 409-38 JAPAN

Accepted
June 8, 1994

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