Hemosuccus pancreaticus caused by gastroduodenal artery pseudoaneurysm associated with chronic pancreatitis: A case report and review of literature

Table 1 Laboratory test results on admission

Complete blood count	Results	Reference range	Unit
White blood cell count	8.00	3.50-9.50	109/L
Red blood cell count	2.34	4.30-5.80	109/L
Hemoglobin	66	130-175	g/L
Hematocrit	0.192	0.400-0.500
Platelet count	108	125-350	109/L
Total amylase	198	30-100	U/L
D-dimer	6060	0-500	µg/L
C-reactive protein	40.1	0.0-10.0	mg/L
Procalcitonin	0.12	0.00-0.50	ng/mL
Serum albumin	24	40-55	g/L

Table 2 Salient clinical features of hemosuccus pancreaticus

Characteristic	n (%)
Causes	118
Splenic artery pseudoaneurysm	23 (19.5)
Gastroduodenal artery pseudoaneurysm	21 (17.8)
Other aneurysms or pseudoaneurysms	37 (31.4)
Pancreatic tumors	14 (11.9)
Vascular diseases	8 (6.8)
EUS-FNA	3 (2.5)
Surgery	2 (1.7)
Trauma	1 (0.8)
Unclear causes	9 (7.6)
Symptoms
Melena	62 (52.5)
Abdominal pain	54 (45.8)
Hematemesis	31 (26.3)
Hematochezia	16 (13.6)
Gastrointestinal bleeding	11 (9.3)
Lab results
Hyperamylasemia	5 (4.2)
Hyperbilirubinemia	2 (1.7)
Endoscopic findings	118
Positive1	56 (47.5)
Negative2	62 (52.5)
Imaging findings	118
Positive3	74 (62.7)
Negative4	44 (37.2)
Treatment	118
Artery embolization	52 (44.1)
Surgery	45 (38.1)
Stent placement	9 (7.6)
Conservative treatment	9 (7.6)
Thrombin injection	4 (3.4)

¹Positive: Esophagogastroduodenoscopy or side-viewing duodenoscopy observed bleeding from the ampulla of Vater.

²Negative: Esophagogastroduodenoscopy or side-viewing duodenoscopy did not observe bleeding from the ampulla of Vater.

³Positive: Imaging results suggest the cause of hemosuccus pancreaticus.

⁴Negative: Imaging results fail to suggest the cause of hemosuccus pancreaticus. EUS-FNA: Endoscopic ultrasound-fine need aspiration.