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CASE REPORT
Year : 2018  |  Volume : 9  |  Issue : 3  |  Page : 134-137

Upper gastrointestinal bleed: Do not forget a look at ampulla


Department of Gastroenterology, Ramaiah Memorial Hospitals, Bengaluru, Karnataka, India

Correspondence Address:
Avinash Bhat Balekuduru
Department of Gastroenterology, Ramaiah Memorial Hospitals, Bengaluru - 560 054, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jde.JDE_25_18

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Hemosuccus pancreaticus (HP) and hemobilia (HB) are uncommon causes of upper gastrointestinal bleed. In this report, 4 cases of HP and 1 case of HB with intermittent bleeding are described. The causes of HP are rupture of splenic artery pseudoaneurysm in 3 and gastroduodenal artery aneurysm in one. The cause of HB is due to cystic artery bleed. HP can be secondary to chronic or acute pancreatitis with bleeding from pseudoaneurysm arising from peripancreatic arteries. Iatrogenic transhepatic techniques, trauma, operative injuries, malignancy, and inflammation in hepatobiliary system are the common causes of HB. All the cases are missed on first endoscopy and diagnosed on second-look endoscopy. A strong clinical suspicion is required at first endoscopy for early diagnosis and management. This case report compares presentation of HP with HB, diagnosis, and their management.


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