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Z Gastroenterol 2014; 52(11): 1263-1267
DOI: 10.1055/s-0034-1385320
Kasuistik
© Georg Thieme Verlag KG Stuttgart · New York

Chronic Pancreatitis with Hemosuccus Pancreaticus. The Diagnostic Contribution of Computed Tomography and Contrast Enhanced Ultrasonography – Case Report

Chronische Pankreatitis mit Haemosuccus pancreaticus. Über den diagnostischen Beitrag der Computertomografie und Kontrastmittelsonografie – eine Kasuistik
C. Caraiani
1   Department of Radiology and Computed Tomography, “Octavian Fodor” Institute of Gastroenterology and Hepatology, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
,
L. Chiorean
2   Department of Ultrasonography, “Octavian Fodor” Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania
,
O. Pascu
3   Department of Gastroenterology, “Octavian Fodor” Institute of Gastroenterology and Hepatology, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
,
L. Ciobanu
3   Department of Gastroenterology, “Octavian Fodor” Institute of Gastroenterology and Hepatology, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
,
A. Seicean
3   Department of Gastroenterology, “Octavian Fodor” Institute of Gastroenterology and Hepatology, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
,
N. Al Hajjar
4   Department of Surgery, “Octavian Fodor” Institute of Gastroenterology and Hepatology, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
,
T. Zaharie
5   Department of Pathology, “Octavian Fodor” Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania
,
R. Badea
6   Department of Ultrasonography, “Octavian Fodor” Institute of Gastroenterology and Hepatology, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
› Author Affiliations
Further Information

Publication History

17 April 2014

11 September 2014

Publication Date:
12 November 2014 (online)

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Chronic Pancreatitis with Hemosuccus Pancreaticus. The Diagnostic Contribution of Computed Tomography and Contrast Enhanced Ultrasonography – Case ReportZ Gastroenterol 2014; 52(11): E1-E1
DOI: 10.1055/s-0034-1399267

Abstract

Hemosuccus pancreaticus is defined as upper gastrointestinal hemorrhage from the ampulla of Vater via the pancreatic duct. It is a rare disease, with non-specific presentation, challenging to diagnose and difficult to treat, with high mortality rates in untreated patients with massive bleeding. Given the intermittent nature of the bleeding, delays in diagnosis frequently occur. Timely diagnosis and treatment seem to result in markedly reduced mortality, therefore we emphasize the diagnostic contribution of imaging techniques by presenting the case of a patient with chronic pancreatitis in whom computed tomography established the diagnosis of blood in the Wirsung duct and contrast-enhanced ultrasound brought its added value by excluding the active bleeding.

Zusammenfassung

Haemosuccus pancreaticus ist definiert als eine obere gastrointestinale Blutung aus dem Ductus Wirsungianus durch die Papilla Vateri. Diese seltene aber bedrohliche Blutung ist durch ihre typischerweise intermittierende Symptomatik charakterisiert und nur schwer zu diagnostizieren und therapieren. Eine frühzeitige Diagnose ermöglicht bessere Behandlungsoptionen mit einer Reduktion der Mortalität. In der hier vorgestellten Kasuistik wird die Bedeutung der Bildgebung diskutiert. Die Computertomografie erbrachte den Nachweis von Blut im Pankreasgang und die Kontrastmittelsonografie konnte eine aktive Blutung ausschließen.

Schlüsselwörter

Haemosuccus pancreaticus - Computertomografie - gastrointestinale Blutung - Kontrastmittelsonografie - chronische Pankreatitis - Pankreasgang

Key words

hemosuccus pancreaticus - computed tomography - gastrointestinal hemorrhage - contrast-enhanced ultrasound - chronic pancreatitis - pancreatic duct
 

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