1/63. Haemosuccus pancreaticus: a clinical challenge.BACKGROUND: Haemosuccus pancreaticus is a rare complication of pancreatitis. It is a diagnostic problem for even the most astute clinician and a challenge for the expert endoscopist. We report a 25-year-old male patient who had all the features usually seen in haemosuccus pancreaticus patients: recurrent obscure upper gastrointestinal bleeding, pancreatitis, pseudocyst formation, ductal disruption, fistula and pancreatic ascites. The patient was treated by subtotal pancreatectomy, splenectomy and drainage of the pseudocyst. Although pancreatic duct communication with the surrounding vasculature could not be ascertained, we strongly believe the patient had haemosuccus pancreaticus because, over a follow-up period of 3 years, the patient was not only ascites free, but did not experience any further upper gastrointestinal bleeding. We believe that in evaluating patients with recurrent obscure gastrointestinal bleeding, one should always remember that the pancreas is a part of the gastrointestinal tract and, like other organs, is prone to blood loss.- - - - - - - - - - ranking = 1keywords = pseudocyst (Clic here for more details about this article) |
2/63. Post-traumatic pancreatitis with associated aneurysm of the splenic artery: report of 2 cases and review of the literature.In patients with acute pancreatitis, profuse gastrointestinal bleeding is associated with a high death rate. The cause of such bleeding must be evaluated and the bleeding controlled urgently. aneurysm formation is usually the cause of the bleeding. angiography is needed to make a definitive diagnosis and the bleeding site should be controlled by angiographic embolization if possible. If this fails, aneurysm resection is necessary. Two patients are described. Both had aneurysms of the splenic artery, presenting as massive gastrointestinal bleeding in one patient and bleeding into an associated pseudocyst in the other. They required surgical repair, which was successful in both cases.- - - - - - - - - - ranking = 0.5keywords = pseudocyst (Clic here for more details about this article) |
3/63. pancreatic pseudocyst: heparin-induced haemorrhage through the ampulla of vater.Bleeding from a pancreatic pseudocyst through the ampulla of vater is a rare cause of overt gastrointestinal haemorrhage. Previously described mechanisms of such haemorrhage are reviewed. We report a case of a 74-year-old female with a pancreatic pseudocyst that bled into the gastrointestinal tract following the administration of heparin. We believe that this is the first reported case of its kind.- - - - - - - - - - ranking = 15.543637638929keywords = pancreatic pseudocyst, pseudocyst (Clic here for more details about this article) |
4/63. pancreatic pseudocyst with hemorrhage into the gastrointestinal tract through the duct of Wirsung.A case of massive upper gastrointestinal hemorrhage is presented in which a pancreatic pseudocyst eroded into the splenic artery resulting in intracystic hemorrhage through the duct of Wirsung. Total excision of the pseudocyst, spleen, and tail of the pancreas is recommended.- - - - - - - - - - ranking = 9.2718188194644keywords = pancreatic pseudocyst, pseudocyst (Clic here for more details about this article) |
5/63. Hemosuccus pancreaticus complicating chronic pancreatitis: an obscure cause of upper gastrointestinal bleeding.BACKGROUND: Hemosuccus pancreaticus, a rare form of upper gastrointestinal bleeding, may complicate chronic pancreatitis and pose a significant diagnostic and therapeutic dilemma. AIM: To present our experience with this potentially life-threatening complication of chronic pancreatitis. methods: We reviewed our experience with management (both operative as well as angiographic embolization) of patients with hemosuccus pancreaticus complicating histologically documented chronic pancreatitis between 1976 and 1997. diagnosis of hemosuccus pancreaticus was based on clinical presentation, preoperative endoscopic and radiographic imaging, operative findings, and pathologic evaluation. RESULTS: During the period, we managed eight patients with hemosuccus pancreaticus (1.5% of all patients with chronic pancreatitis treated surgically). Gastrointestinal bleeding presented as hematemesis in three and hematochezia in three, but all had recent melena and were anemic; three of these patients were hemodynamically unstable. abdominal pain was present in six. When performed, angiography (n=6) was diagnostic of a pseudoaneurysm; computed tomography (n=7) showed a pseudoaneurysm in two and a pseudocyst in five. endoscopy (n=8) revealed blood issuing from the ampullary papilla in two patients. Operative management (n=6) involved distal pancreatectomy, pancreatoduodenectomy, or total pancreatectomy in two patients each. Angiographic embolization was successful in one patient, but the other died from uncontrollable hemorrhage. CONCLUSIONS: Hemosuccus pancreaticus is rare, but should be considered in patients with chronic pancreatitis and gastrointestinal bleeding. In the absence of pancreatitis-related indications for surgery, angiographic embolization can be definitive treatment. If there are pancreatitis-related indications for operation, angiographic embolization may allow an elective operative procedure based on structural changes of the pancreas. If embolization fails, pancreatic resection is usually required, often on an emergent basis.- - - - - - - - - - ranking = 0.5keywords = pseudocyst (Clic here for more details about this article) |
6/63. Haemobilia from pancreatic cystadenoma.Hamobilia from a pancreatic source is a rare cause of gastrointestinal haemorrhage. Most of the reported cases have arisen from haemorrhage into a pancreatic pseudocyst, which is frequently fatal. This report describes a patient with gastrointestinal haemorrhage arising from a pancreatic cystadenoma.- - - - - - - - - - ranking = 6.7718188194644keywords = pancreatic pseudocyst, pseudocyst (Clic here for more details about this article) |
7/63. A retroperitoneal cystic leiomyosarcoma spontaneously draining into the stomach.An unusual case of a retroperitoneal cystic leiomyosarcoma clinically resembling a pancreatic pseudocyst with subsequent spontaneous cystgastrostomy drainage is presented.- - - - - - - - - - ranking = 6.7718188194644keywords = pancreatic pseudocyst, pseudocyst (Clic here for more details about this article) |
8/63. pancreatic pseudocyst as a cause of gastrointestinal bleeding and hemobilia. A case report.A case of hemobilia from a pancreatic pseudocyst which developed after cholecystostomy and aspiration of the pseudocyst, intended to relieve biliary obstruction, is discussed. These previously reported cases are briefly reviewed.- - - - - - - - - - ranking = 9.2718188194644keywords = pancreatic pseudocyst, pseudocyst (Clic here for more details about this article) |
9/63. A pancreatic pseudocyst with acute hemorrhage in a child--secondary to a spherical duodenal duplication? A case report.Duodenal duplications are rare congenital malformations with variable and non-specific symptoms. A spherical duodenal duplication associated with a pancreatic pseudocyst causing an acute bleeding due to a vascular erosion in a 16-month old child is presented. The possibility of a causal relationship between duodenal duplication and pancreatic pseudocyst is discussed.- - - - - - - - - - ranking = 40.630912916787keywords = pancreatic pseudocyst, pseudocyst (Clic here for more details about this article) |
10/63. A case of haemosuccus pancreaticus.Haemosuccus pancreaticus (Wirsungorrhagia or pseudohaemobilia) is a rare complication of chronic pancreatitis. We describe a 48-year-old patient with alcohol-induced chronic calcific pancreatitis and recurrent episodes of severe upper gastrointestinal bleeding but without abdominal pain. Upper gastrointestinal endoscopy revealed fresh blood oozing from the ampulla of vater. No pseudoaneurysms or pseudocysts were detected by arteriography or computerized tomography. The bleeding was attributed to pancreatic lithiasis. Following conservative treatment, there was no evidence of recurrence during a 24-month follow-up period. In conclusion, although a rare occurrence, haemosuccus pancreaticus should be considered in the differential diagnosis of all cases of obscure upper gastrointestinal bleeding in patients with chronic pancreatitis, whether or not accompanied by pain. A highly suggestive clinical history or X-ray findings and an endoscopic visualization of blood coming from the ampulla of vater may suffice for the diagnosis, thus avoiding diagnostic and therapeutic errors. When haemosuccus pancreaticus occurs in patients without pseudoaneurysms or pseudocysts, it can be treated conservatively, thus obviating the need for pancreatectomy or arteriographic embolization.- - - - - - - - - - ranking = 1keywords = pseudocyst (Clic here for more details about this article) |
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