Breaking the silence: a case report of hemosuccus pancreaticus as a rare cause of gastrointestinal bleeding

Hemosuccus pancreaticus is an uncommon but potentially life-threatening cause of upper gastrointestinal bleeding. We report the case of a 47-year-old man with a history of alcohol use disorder and alcohol use disorder and a previous episode of alcohol-induced acute pancreatitis who presented with melena, severe microcytic anemia, and recurrent epigastric pain. Upper endoscopy demonstrated blood emerging from the major papilla alternating with bile, raising suspicion for hemosuccus pancreaticus. Contrast-enhanced computed tomography revealed a large pseudoaneurysm of the pancreatoduodenal artery within the pancreatic head, likely secondary to chronic inflammatory changes. The patient underwent successful endovascular coil embolization, resulting in complete cessation of bleeding and an uneventful recovery. This case highlights the role of upper endoscopy in early recognition of hemosuccus pancreaticus and underscores the effectiveness of endovascular therapy in managing pseudoaneurysm-related hemorrhage.