A case of bleeding from the accessory pancreatic duct associated with aneurysmal dilatation of pancreaticoduodenal artery / 대한내과학회지

Gastrointestinal bleeding through the pancreatic duct especially from the minor papilla through the accessory duct is a very rare event. It has rarely been demonstrated to be associated with pancreatic pseudocyst, arteriovenous malformation, pancreas divisum, and duodenal duplication cyst. We have experienced a 51-year old man having sudden onset melena. He had been recovered from a recent myocardial infarction and was on the aspirin treatment. Upper gastrointestinal endoscopic examination revealed bleeding through minor papilla from the accessory duct but no bleeding was observed through the ampulla of Vater. Angiogram demonstrated two sites of aneurysmal dilatation of pancreaticoduodenal artery and these were obliterated by selective embolization. Thereafter the bleeding was controlled and patient was recovered.

A case of bleeding from the accessory pancreatic duct associated with aneurysmal dilatation of pancreaticoduodenal artery / 대한내과학회지

Gastrointestinal bleeding through the pancreatic duct especially from the minor papilla through the accessory duct is a very rare event. It has rarely been demonstrated to be associated with pancreatic pseudocyst, arteriovenous malformation, pancreas divisum, and duodenal duplication cyst. We have experienced a 51-year old man having sudden onset melena. He had been recovered from a recent myocardial infarction and was on the aspirin treatment. Upper gastrointestinal endoscopic examination revealed bleeding through minor papilla from the accessory duct but no bleeding was observed through the ampulla of Vater. Angiogram demonstrated two sites of aneurysmal dilatation of pancreaticoduodenal artery and these were obliterated by selective embolization. Thereafter the bleeding was controlled and patient was recovered.

A Case of Inflammatory Fibroid Polyp Presenting with Jejunal Bleeding / 대한소화기학회지

Inflammatory fibroid polyp occurs very rarely in the jejunum and gastrointestinal bleeding as an initial manifestation of inflammatory fibroid polyp has not been reported. We report a case of a jejunal inflammatory fibroid polyp presenting with melena for 10 days. Upper gastrointestinal endoscopic examination was negative for any active bleeding lesions and abdominal angiography failed to localize the bleeding site as well. In contrast, computed tomography of the abdomen demonstrated a segmental wall thickening of the jejunum with a tumor-like mass lesion associated with dense contrast enhancement. Consistent with this, technetium 99m red blood cells scintigraphy exhibited red cell pooling at the right upper quadrant. On exploratory laparotomy, there was an active bleeding from the site of the jejunal tumor and a segmental resection was performed. Histologically, the tumor lesion of the jejunum was consistent with inflammatory fibroid polyp. Thus, we conclude that the tumor lesion was a cause of the gastrointestinal bleeding.