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

ABSTRACT

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.