Resumo
Hemosuccus pancreaticus is a unusual syndrome manifested by hemorrhage into the pancreatic duct and by blood loss through the ampulla of Vater: It may be caused by tumors, arteriovenous malformation, pancreatic lithiasis, aneurism rupture from adjacent vessels, or erosion of pancreatic and peripancreatic vessels due to chronic pancreatitis. The authors describe a case of massive and recurrent gastrointestinal upper hemorrhage in a 26-year-old man without known risk factors for pancreatitis. This man underwent urgent surgery due to gastrointestinal bleeding during the ínvestigation. During the procedure, blood was found in the intestinal lumen and a tumor in the head of pancreas with two centimeters of diameter: A gastroduodenopancreatectomy was performed. Histological study showed chronic pancreatitis with a fistula from the pancreatic vessels to the Wirsung duct. The patient was discharged without postoperative complications and after months, remains assymptomatic.
Hemosuccus pancreaticus; Massive digestive hemorrhage
Hemosuccus pancreaticus; Massive digestive hemorrhage
RELATOS DE CASOS
Hemosuccus pancreaticus: causa rara de hemorragia digestiva maciça
Hemosuccus pancreaticus: a rare case of massive digestive hemorrhage
Fernando Antonio C. Spencer, ACBC.PEI; Euclides Martins Filho, RCBC.PEI; Miguel Arcanjo dos Santos Júnior, TCBC.PEII; Edmundo Machado Ferraz, TCBC.PEIII
IResidente do Serviço de Cirurgia Geral do HC-UFPE
IICirurgião do Serviço de Cirurgia Geral do HC-UFPE
IIIProfessor Titular e Chefe do Serviço de Cirurgia Geral HC-UFPE
Endereço para correspondência Endereço para correspondência: Dr. Fernando Antônio C. Spencer Netto Rua Almirante Tamandaré, 137/301 51030-090 - Recife-PE
ABSTRACT
Hemosuccus pancreaticus is a unusual syndrome manifested by hemorrhage into the pancreatic duct and by blood loss through the ampulla of Vater: It may be caused by tumors, arteriovenous malformation, pancreatic lithiasis, aneurism rupture from adjacent vessels, or erosion of pancreatic and peripancreatic vessels due to chronic pancreatitis. The authors describe a case of massive and recurrent gastrointestinal upper hemorrhage in a 26-year-old man without known risk factors for pancreatitis. This man underwent urgent surgery due to gastrointestinal bleeding during the ínvestigation. During the procedure, blood was found in the intestinal lumen and a tumor in the head of pancreas with two centimeters of diameter: A gastroduodenopancreatectomy was performed. Histological study showed chronic pancreatitis with a fistula from the pancreatic vessels to the Wirsung duct. The patient was discharged without postoperative complications and after months, remains assymptomatic.
Key words: Hemosuccus pancreaticus; Massive digestive hemorrhage.
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Recebido em 28/8/98
Aceito para publicação em 11/1/99
Trabalho realizado no Serviço de Cirurgia Geral do Hospital das Clínicas da Universidade Federal de Pernambuco - HC-UFPE.
- 1. Luna LL, Vargas C, Rodriguez CMS, et al - Hemorragia digestiva alta năo varicosa: diagnóstico e tratamento endoscópico. In: Endoscopia Digestiva. Editora Medsi. Rio de Janeiro. Primeira ediçăo 1994; 459-482.
- 2. Clay RP, Farnell MB, Lancaster RJ, Weiland LH, Gostout CJ - Hemosuccus pancreaticus - An unusual cause of upper gastrointestinal bleeding. Ann Surg 1985;202:75-79.
- 3. Camishion RC, Pello MJ, Spence RK, et al - Hemoductal pancreatitis. Surgery 1992;111:86-89.
- 4. Suter M, Doens F, Chapuis G, et al - Haemorrhage into pancreatic duct (Hemosuccus pancreaticus): recognition and management. Eur J Surg 1995;161:887-892.
- 5. Risti B, Marincek B, Jost R, et al- Hemosuccus pancreaticus as a source of obscure upper gastrointestinal bleeding: three cases and literature review. The American Journal of Gastroenterology 1995;90: 1878-1980.
Endereço para correspondência:
Datas de Publicação
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Publicação nesta coleção
09 Fev 2010 -
Data do Fascículo
Abr 1999
Histórico
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Aceito
11 Jan 1999 -
Recebido
28 Ago 1998