Hemosuccuspancreaticus:ararecauseof gastrointestinalbleeding

摘要

BACKGROUND: Hemosuccus  pancreaticus  (HP)  is  deifned as upper gastrointestinal (GI) hemorrhage from the papilla of Vater via the pancreatic duct and is a rare cause of digestive bleeding. DATA SOURCE: A PubMed search of relevant articles published from  January  1967  to  September  2011  was  performed  to identify current information about HP in terms of its etiology, pathophysiology,  clinical  presentation,  diagnosis  and management. RESULTS: A  variety  of  etiological  factors,  most  commonly chronic pancreatitis but also tumors and vascular diseases, can lead to this condition. Appropriate endoscopic or radiologic procedures should be chosen to establish a precise diagnosis for patients, especially those with a known history of pancreatic disorders, who present with abdominal pain, GI hemorrhage and  hyperamylasemia.  There  are  two  main  therapeutic options for this condition: angiographic embolotherapy and surgery. Both treatments can stop bleeding, but angiographic embolotherapy is the treatment of choice for stable patients. Recently, new and less invasive treatments have emerged to treat this condition. CONCLUSIONS: Because  of  its  rarity  and  broad  spectrum of  causes,  HP  is  dififcult  to  diagnose  accurately.  However, appropriate endoscopic and radiologic procedures are extremely helpful for establishing a correct diagnosis. Both angiographic embolotherapy and surgery are reliable treatment options for this condition, and transcatheter intervention is the treatment of choice for clinically stable patients. Additional innovative treatments have emerged, but their effectiveness and safety must be conifrmed.