International Journal of Health Sciences & Research (www.ijhsr.org) 338 Vol.7; Issue: 2; February 2017 International Journal of Health Sciences and Research www.ijhsr.org ISSN: 2249-9571 Case Report Hemosuccus Pancreaticus: A Rare Entity B. Ananda Rama Rao 1 , Rama Lakshmi. T.N 2 , P.Sai Kumar 2 1 Prof of Surgery, 2 Resident in Surgery, SVS Medical College, Mahabub Nagar Telangana - 500902 Corresponding Author: B. Ananda Rama Rao Received: 28/12/2016 Revised: 09/01/2017 Accepted: 10/01/2017 ABSTRACT Hemosuccus pancreaticus, also named as Wirsungorrhagia or psuedohematobilia is a rare condition of intermittent hemorrhage from upper gastrointestinal tract. The source of bleeding is from a visceral aneurysm into main pancreatic duct in patients with chronic pancreatitis. It is a life threatening complication of pancreatitis and a significant diagnostic challenge due to its intermittent nature and rarity. This is a case of male patient with chronic pancreatitis presenting with hemosuccus pancreatitis from an aneurysm of splenic artery, treated successfully by distal pancreatectomy and spleenectomy. Key Words: Hemosuccus Pancreatitis Splenic artery aneurysm Splenectomy INTRODUCTION Hemosuccus pancreaticus is an unusual complication of pancreatitis with intermittent hemorrhage in upper gastrointestinal tract from a visceral aneurysm into the main pancreatic duct. The hemorrhage ranges from intermittent occult bleed up to severe bleeding causing death. It was by Lower and Farrellin the year 1931, who first reported that the source of hemorrhage was from aneurysm of splenic artery into main pancreatic duct. [1] It is also called as Pseudohematobilia or Wirsungorrhagia. In 1970, Sandblom coined the term Hemosuccus pancreaticus. [2] This condition is of diagnostic challenge due to its intermittent nature and rarity. This is one such case of Hemosuccus pancreaticus in a chronic pancreatitis patient with aneurysm of splenic artery as a source of bleeding. CASE REPORT A 42yr old male patient came with complaints of bouts of recurrent hemetemesis following a colicky abdominal pain since one year. He had severe anaemia for which five units of blood was transfused. Upper gastrointestinal endoscopy reported oesophagitis and fundal gastritis for which he was treated conservatively. Colonoscopy reported normal. Ultrasonological imaging showed chronic pancreatitis and was further evaluated with computed tomography which reported the same with pseudo pancreatic cyst at tail of pancreas (Figure 1) and aneurysm of splenic artery which was delineated on magnetic resonance angiogram (Figure 2). The hematological report showed improvement in haemoglobin level (8gm%) after blood transfusion with low hematocrit value (24vol%). Liver and renal function tests were within normal limits. Patient was operated, distal pancreatectomy with ligation of splenic artery aneurysm and splenectomy was done (Figure 3,4). A pseudocyst was seen at tail of pancreas (Figure 5) and splenic infarct