Hemosuccus pancreaticus associated with severe acute pancreatitis and pseudoaneurysms: a report of two cases.

CONTEXT Hemosuccus pancreaticus is a rare cause of upper gastrointestinal hemorrhage. The intensity of bleeding ranges from intermittent occult bleeding to massive acute bleeding leading to death. Although most cases can be managed by angioembolization, surgery plays an important role. CASE REPORT We report two cases of hemosuccus pancreaticus managed at our institution in the past three years. Both cases occurred associated with acute pancreatitis. A pseudocyst was found in one case. Angioembolization failed in one case and was not tried in the other because of hemodynamic instability. Both cases were successfully managed by surgery. CONCLUSION Timely intervention, either by embolization or by surgery, can control this potentially life-threatening bleeding. Choice of treatment, surgery or embolization, depends on technological availability and expertise of the practitioner.