Clinical Management of Pediatric Hemosuccus Pancreaticus: Experience Based on a Case Report and Mini Literature Review
- 1Department of Pediatric Surgery The Second Affiliated Hospital Xi’an Jiaotong University No 157, Xi Wu Road Xi’an 710004 China xjtu.edu.cn
- 2Department of Radiology The Second Affiliated Hospital Xi’an Jiaotong University No 157, Xi Wu Road Xi’an 710004 China xjtu.edu.cn
- 3Department of Ultrasound Medicine The Second Affiliated Hospital Xi’an Jiaotong University No 157, Xi Wu Road Xi’an 710004 China xjtu.edu.cn
Abstract
Objective: Hemosuccus pancreaticus (HP) rarely happens in children, and early diagnosis poses significant challenges. It aims to elucidate the clinical characteristics and management of pediatric HP.
Methods: To retrospectively analyzes a pediatric HP case admitted to our department, along with a narrative literature review.
Results: A 13‐year‐old boy presented intermittent epigastric pain with gastrointestinal bleeding (GIB), who previously suffered from chronic pancreatitis. The emergency gastroscopy showed fresh blood overflow from duodenal papilla, and CT angiography (CTA) revealed a pancreatic tail pseudocyst with splenic artery (SpA) involved and occurring pseudoaneurysm, which suggested HP. Twice interventional therapy yielded hemostatic effect while appeared prone to recurrence, laparoscopic resection of pancreatic pseudocyst, SpA pseudoaneurysm and partial splenectomy was performed. The child did not experience recurrence with follow‐up for 2 years. Another 9 children with the age of 3–18 years were reported; 6 cases were diagnosed via CT arteriography and successfully interventional embolized, and 2 cases were diagnosed and treated using endoscopic ultrasonography (EUS).
Conclusion: Pediatric HP is attributed to peripancreatic pseudoaneurysm ruptured into pancreatic duct to duodenum, secondary to pancreatitis, abdominal surgery, or blunt abdominal trauma. Intermittent epigastric pain, GIB, and elevated blood amylase are common clinical features. Endoscopy often missed diagnosis and even requires repeated examination. CTA is recommended for HP diagnosis. Interventional therapy is the first choice but leading to complications, especially patients with failed interventional, ineffective hemostasis or hemodynamic instability can be treated with laparoscopic surgery. Sometimes, the EUS is alternative. Generally, the children if diagnosed in time present good prognosis.
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BibTeX
@article{tian2026clinical,
title = {{Clinical Management of Pediatric Hemosuccus Pancreaticus: Experience Based on a Case Report and Mini Literature Review}},
author = {Donghao Tian and Jialu Fu and Hui Yu and Qiang Liu and Yuekui Luo and Baijun Zheng and Ya Gao},
journal = {Case Reports in Gastrointestinal Medicine},
year = {2026},
month = oct,
doi = {10.1155/crgm/4250947},
url = {https://doi.org/10.1155/crgm/4250947},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Clinical Management of Pediatric Hemosuccus Pancreaticus: Experience Based on a Case Report and Mini Literature Review
AU - Donghao Tian
AU - Jialu Fu
AU - Hui Yu
AU - Qiang Liu
AU - Yuekui Luo
AU - Baijun Zheng
AU - Ya Gao
PY - 2026
DA - 2026/10/26
JO - Case Reports in Gastrointestinal Medicine
DO - 10.1155/crgm/4250947
UR - https://doi.org/10.1155/crgm/4250947
AB - Objective: Hemosuccus pancreaticus (HP) rarely happens in children, and early diagnosis poses significant challenges. It aims to elucidate the clinical characteristics and management of pediatric HP. Methods: To retrospectively analyzes a pediatric HP case admitted to our department, along with a narrative literature review. Results: A 13‐year‐old boy presented intermittent epigastric pain with gastrointestinal bleeding (GIB), who previously suffered from chronic pancreatitis. The emergency gastroscopy showed fresh blood overflow from duodenal papilla, and CT angiography (CTA) revealed a pancreatic tail pseudocyst with splenic artery (SpA) involved and occurring pseudoaneurysm, which suggested HP. Twice interventional therapy yielded hemostatic effect while appeared prone to recurrence, laparoscopic resection of pancreatic pseudocyst, SpA pseudoaneurysm and partial splenectomy was performed. The child did not experience recurrence with follow‐up for 2 years. Another 9 children with the age of 3–18 years were reported; 6 cases were diagnosed via CT arteriography and successfully interventional embolized, and 2 cases were diagnosed and treated using endoscopic ultrasonography (EUS). Conclusion: Pediatric HP is attributed to peripancreatic pseudoaneurysm ruptured into pancreatic duct to duodenum, secondary to pancreatitis, abdominal surgery, or blunt abdominal trauma. Intermittent epigastric pain, GIB, and elevated blood amylase are common clinical features. Endoscopy often missed diagnosis and even requires repeated examination. CTA is recommended for HP diagnosis. Interventional therapy is the first choice but leading to complications, especially patients with failed interventional, ineffective hemostasis or hemodynamic instability can be treated with laparoscopic surgery. Sometimes, the EUS is alternative. Generally, the children if diagnosed in time present good prognosis.
SN - 2090-6528
SN - 2090-6536
ER -