Pseudo to pseudo connection: pseudoaneurysm draining into the pseudocyst causing pseudohaemobillia

BMJ Case Rep. 2019 Mar 6;12(3):e228441. doi: 10.1136/bcr-2018-228441.

Abstract

Haemosuccus pancreaticus (HP) is an exceedingly rare cause of lower gastrointestinal (GI) bleed where pseudoaneurysm of the peripancreatic vessels ruptures into a pancreatic pseudocyst and blood travel through the pancreatic duct, thereby, draining into GI tract via the ampulla of Vater. 1 We present a case of 65-year-old African-American woman with a history of alcohol abuse presented with melena for 1 day. The contrast-enhanced CT of abdomen/pelvis showed peripancreatic vascular pseudoaneurysm with active haemorrhage. Angiography confirmed the diagnosis of HP and successful transcatheter embolisation was performed.

Keywords: gastroenterology; gi bleeding.

Publication types

  • Case Reports

MeSH terms

  • Abdomen / diagnostic imaging
  • Aged
  • Alcoholism / complications
  • Alcoholism / psychology
  • Aneurysm, False / complications
  • Aneurysm, False / diagnostic imaging*
  • Aneurysm, False / pathology
  • Aneurysm, False / therapy
  • Angiography / methods
  • Black or African American / ethnology
  • Embolization, Therapeutic / methods
  • Female
  • Gastrointestinal Hemorrhage / diagnosis
  • Gastrointestinal Hemorrhage / etiology
  • Hemobilia / etiology*
  • Humans
  • Melena / diagnosis*
  • Pancreatic Pseudocyst / complications
  • Pancreatic Pseudocyst / diagnostic imaging*
  • Pancreatic Pseudocyst / pathology
  • Tomography, X-Ray Computed
  • Treatment Outcome