Editor's quiz: GI snapshot
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From the question on page 878
Upper gastrointestinal endoscopy showed blood-like material effusing from the papilla of Vater. Abdominal ultrasonography disclosed a pseudoaneurysm at the pancreatic body; CT scan showed coeliac dissection with a complicated pseudoaneurysm. Haemosuccus pancreaticus was diagnosed. After oblique coronal and sagittal reformation, the true lumen and dilated pseudoaneurysm of coeliac dissection were clearly shown (fig 1). We believed the aetiology of haemosuccus pancreaticus to be related to coeliac dissection. Laparotomy was performed and the pseudoaneurysm was seen to be joined to a blood-filled pancreatic duct. The coeliac pseudoaneurysm was about 5 cm in size, occupying splenic and left gastric arteries. The common hepatic artery was not involved. Distal pancreatectomy and splenectomy were then performed smoothly. The patient was discharged after 10 days hospitalisation and has been doing well with no recurrence of bleeding for 4 months.
Bleeding through the pancreatic duct was first described by Lower
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Gut 2008 57: 878.[Extract] [Full Text] [PDF]
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