Case report: Haemosuccus pancreaticus: A clinical challenge

Background: Haemosuccus pancreaticus is a rare complication of pancreatitis . It is a diagnostic problem for even the most astute clinician and a chall enge for the expert endoscopist. We report a 25-year-old male patient who h ad all the features usually seen in haemosuccus pancreaticus patients: recu rrent obscure upper gastrointestinal bleeding, pancreatitis, pseudocyst for mation, ductal disruption, fistula and pancreatic ascites. The patient was treated by subtotal pancreatectomy, splenectomy and drainage of the pseudoc yst. Although pancreatic duct communication with the surrounding vasculatur e could not be ascertained, we strongly believe the patient had haemosuccus pancreaticus because, over a follow-up period of 3 years, the patient was not only ascites free, but did not experience any further upper gastrointes tinal bleeding. We believe that in evaluating patients with recurrent obscu re gastrointestinal bleeding, one should always remember that the pancreas is a part of the gastrointestinal tract and, like other organs, is prone to blood loss.