Hemosuccus Pancreaticus
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Case:

A 3-year-old boy presented with recurrent episodes of hematochezia and melena of varying severity, associated with abdominal pain and progressive pallor of 6 months duration requiring multiple blood transfusions. At one and half years of age, he was conservatively treated for acute pancreatitis presenting with ascites. Clinically he was anemic (Hb 7 g/dL), and undernourished (weight and height below 3rd centile). Systemic examination was normal. Provisional diagnosis of Hemosuccus pancreaticus was considered and investigated. Liver function tests, serum amylase, lipase, and renal function tests were normal. Upper endoscopy on three different occasions and colonoscopy on two occasions were not contributory. CECT abdomen with angiography showed features of chronic pancreatitis without any vessel abnormality. An emergency gastroscopy was done during the episode of hematochezia, which revealed active oozing of blood from ampulla suggestive of Hemosuccus pancreaticus. Conventional angiography of selective celiac axis/superior mesenteric artery (done elsewhere) showed a leak in the gastroduodenal artery, and two coils (2mm × 2cm and 3mm × 3cm) were deployed. Child is asymtomatic on follow up for more than a year.....

http://www.indianpediatrics.net/feb2017/feb-147-148.htm
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