SHM Converge Scientific Abstract ePoster Gallery-Hemosuccus Pancreaticus: A Rare Culprit Behind Recurrent Gi Bleeding

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This case describes a 34-year-old man with several months of intermittent melena, progressive weakness, tachycardia, pallor, and profound anemia (hemoglobin 1.5) without abdominal pain or other typical GI symptoms. Initial CT angiogram was unrevealing, highlighting how hemosuccus pancreaticus can be missed because bleeding is intermittent and imaging may be negative between episodes.<br /><br />He was admitted to the ICU, treated with massive transfusion support, and underwent GI endoscopy, which showed active bleeding from the major duodenal papilla—a key clue for hemosuccus pancreaticus. Given the high-risk nature of surgery, interventional radiology performed prophylactic embolization of the gastroduodenal artery, after which his hemoglobin stabilized and bleeding stopped. He was discharged with close follow-up and has had no recurrent bleeding.<br /><br />The report emphasizes that hemosuccus pancreaticus is a rare but important cause of recurrent upper GI bleeding, especially in patients with pancreatitis or pancreatic cysts. Because standard workups, including CTA, can be falsely negative, clinicians should pursue repeat or alternative imaging when suspicion remains high. Early involvement of gastroenterology and interventional radiology was critical in this case and may prevent further bleeding and reduce the need for surgery. The case underscores the hospitalist’s role in recognizing uncommon causes of GI bleeding and coordinating timely multidisciplinary care.

Asset Subtitle

Akriti Jalla

Meta Tag

Author List Akriti Jalla, Ashley M. Perry, Robert M. Krahmer

Category Clinical Vignettes

Concept Hemosuccus Pancreaticus

Concept Upper Gastrointestinal Bleeding

Concept Rebleeding

Concept Unexplained Bleeding

Concept Endoscopy

Distinguished Non-Finalist

Presenter Organization University of South Florida

Presenting Author Akriti Jalla

Track Adult

Keywords

hemosuccus pancreaticus

gastrointestinal bleeding

melena

duodenal papilla

gastroduodenal artery embolization

pancreatitis

massive transfusion

interventional radiology

upper GI bleeding

anemia

Hemosuccus Pancreaticus

Upper Gastrointestinal Bleeding

Rebleeding

Unexplained Bleeding

Endoscopy