Hemosuccus Pancreaticus Caused by Rupture of a True Splenic Artery Aneurysm following a Failure of Coil Embolization

Hemosuccus pancreaticus, particularly that caused by a primary aneurysm, is rarely encountered. Thus, its clinical characteristics are not well known. We report the case of a 53-year old man, who presented with hemosuccus pancreaticus caused by the rupture of an atherosclerotic aneurysm of the splenic artery and underwent distal pancreatectomy with splenectomy. Only 16 cases of hemosuccus pancreaticus due to primary aneurysm have previously been reported in the English-language literature between 1970 and 2003. The relevant literature was also reviewed. The review of the literature showed that because diagnosis is difficult to establish due to intermittent hemorrhage, a long time was often taken before definitive treatment was instituted. Treatment based on a definitive or suspected diagnosis reached a satisfactory result; however, the condition can cause a life-threatening situation. When upper gastrointestinal bleeding from an obscure source is encountered, hemosuccus pancreaticus should be considered. We suggest that when an aneurysm of peripancreatic vessels is present, adequate treatment for the aneurysm should be immediately undertaken, even though the site of the bleeding has not been confirmed.