Abstract
Haemosuccus pancreaticus (wirsungorrhagia, santorinirrhagia, haemoductal pancreatitis, pseudohaemobilia) is a rare cause of gastrointestinal bleeding. Haemosuccus pancreaticus is most often due to rupture of pseudoaneurysm of the splenic artery in chronic pancreatitis, pancreatic pseudocysts, and pancreatic tumours.
Bleeding occurs when a pseudocyst or tumour erodes into a vessel, forming a direct communication between the pancreatic duct and blood vessel. It may also be seen after therapeutic endoscopy on the pancreas or pancreatic duct, including pancreatic stone removal, pancreatic duct sphincterotomy, pseudocyst drainage or pancreatic duct stenting.
Other rare causes of haemosuccus pancreaticus include trauma and rupture of primary splenic aneurysm. These primary aneurysms occur more commonly in women, generally presented as a massive intraperitoneal bleeding, most often during pregnancy or in elderly multiparous women.