Two Cases of Hemosuccus Pancreaticus

Kimihiro Igari, Yuichiro Watanabe, Arihiro Aihara, Takanori Ochiai, Youichi Kumagai and Shigeru Yamazaki

Department of Surgery, Ohta Nishinouchi Hospital

Although hemosuccus pancreaticus is a rare complication of chronic pancreatitis, it should be considered in cases of unexplained gastrointestinal bleeding. We report two cases of hemosuccus pancreaticus. Case 1: A 77-year-old man seen for repeated hematemesis was found in computed tomography (CT) to have a splenic artery aneurysm. Hematemesis was considered due to aneurysm rupture into the main pancreatic duct, necessitating surgery. Pathological examination showed the resected specimen to be a true aneurysm without a pseudocyst. Case 2: A 58-year-old man with upper abdominal pain was found in upper gastrointestinal (GI) endoscopy to have bleeding from the papilla of Vater. Abdominal magnetic resonance imaging (MRI) showed a cystic pancreatic tail lesion. We operated based on a diagnosis of hemosuccus pancreaticus due to the pancreatic cyst. Pathological findings of the resected specimen showed mucin-secreting columnar epithelial cells with varying degrees of atypia but without ovarian-type stroma. The definitive diagnosis was hemosuccus pancreaticus due to intraductal mucinouspapillary neoplasm.

Key words
hemosuccus pancreaticus, aneurysm, intraductal papillary mucinous neoplasm

Reprint requests
Kimihiro Igari Department of Surgery, Ohta Nishinouchi Hospital
2-5-20 Nishinouchi, Koriyama, 963-8558 JAPAN

Accepted
April 28, 2010

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