{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T14:20:20Z","timestamp":1767190820065,"version":"3.48.0"},"reference-count":10,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,12,14]]},"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p>Hemosuccus pancreaticus represents an exceedingly rare aetiology of gastrointestinal haemorrhage in the paediatric population, characterised by bleeding emanating from the ampulla of Vater via the pancreatic duct. Its infrequency results in limited data regarding its incidence and management in children. The diagnosis is challenging due to its uncommon occurrence and the concealed nature of the bleeding source, which is frequently overlooked during endoscopic examination. We present three paediatric cases presenting with melena and pancreatitis. Although endoscopy yielded negative results, CT angiography identified haemorrhage originating from pseudoaneurysms of the left gastric, right gastric and splenic arteries, which were subsequently managed with endovascular embolisation. Therefore, hemosuccus pancreaticus should be considered in the differential diagnosis of paediatric patients with pancreatitis and gastrointestinal bleeding, even when endoscopic findings are unremarkable; cross-sectional imaging is essential. The minimally invasive modality of endovascular treatment offers advantages, including reduced morbidity and expedited recovery.<\/jats:p>","DOI":"10.1136\/bcr-2025-269762","type":"journal-article","created":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T11:35:22Z","timestamp":1767180922000},"page":"e269762","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Hemosuccus pancreaticus in paediatric patients: unmasking the concealed haemorrhage of the pancreas by contemplating beyond endoscopy"],"prefix":"10.1136","volume":"18","author":[{"given":"Harsh","family":"Agarwal","sequence":"first","affiliation":[{"name":"Radiodiagnosis, All India Institute of Medical Sciences - Bhubaneswar, Bhubaneswar, Odisha, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aditi","family":"Kumar","sequence":"additional","affiliation":[{"name":"Paediatrics, All India Institute of Medical Sciences - Bhubaneswar, Bhubaneswar, Odisha, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1146-2302","authenticated-orcid":false,"given":"Manoj Kumar","family":"Nayak","sequence":"additional","affiliation":[{"name":"Radiodiagnosis, All India Institute of Medical Sciences - Bhubaneswar, Bhubaneswar, Odisha, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3317-8353","authenticated-orcid":false,"given":"Biswajit","family":"Sahoo","sequence":"additional","affiliation":[{"name":"Radiodiagnosis, All India Institute of Medical Sciences - Bhubaneswar, Bhubaneswar, Odisha, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,12,31]]},"reference":[{"key":"2025123106151533000_18.12.e269762.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0399-8320(05)80755-9"},{"key":"2025123106151533000_18.12.e269762.2","doi-asserted-by":"crossref","DOI":"10.1097\/PG9.0000000000000125","article-title":"Hemosuccus Pancreaticus Following Acute Pancreatitis in a 12-years-old Boy Secondary to Pancreatic Pseudoaneurysm Treated With Endovascular Coil Embolization","volume":"2","author":"Ekezie","year":"2021","journal-title":"JPGN Rep"},{"key":"2025123106151533000_18.12.e269762.3","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1007\/s13312-017-1019-0","article-title":"Hemosuccus Pancreaticus","volume":"54","author":"Bavanandam","year":"2017","journal-title":"Indian Pediatr"},{"key":"2025123106151533000_18.12.e269762.4","doi-asserted-by":"crossref","DOI":"10.1177\/23247096211070388","article-title":"Hemosuccus Pancreaticus: A Comprehensive Review of Presentation Patterns, Diagnostic Approaches, Therapeutic Strategies, and Clinical Outcomes","volume":"10","author":"Tarar","year":"2022","journal-title":"J Investig Med High Impact Case Rep"},{"key":"2025123106151533000_18.12.e269762.5","article-title":"Hemosuccus Pancreaticus: A Rare Cause of Upper Gastrointestinal Bleeding in a Child With Recurrent Acute Pancreatitis and Splenic Artery Aneurysm","volume":"17","author":"Hsayan","year":"2025","journal-title":"Cureus"},{"key":"2025123106151533000_18.12.e269762.6","doi-asserted-by":"publisher","DOI":"10.1016\/S1499-3872(12)60211-2"},{"key":"2025123106151533000_18.12.e269762.7","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1976.01360220131022"},{"key":"2025123106151533000_18.12.e269762.8","doi-asserted-by":"crossref","DOI":"10.5402\/2013\/191794","article-title":"Hemosuccus Pancreaticus: 15-Year Experience from a Tertiary Care GI Bleed Centre","volume":"2013","author":"Rammohan","year":"2013","journal-title":"ISRN Radiol"},{"key":"2025123106151533000_18.12.e269762.9","first-page":"175","article-title":"Hemosuccus pancreaticus: a rare cause of gastrointestinal bleeding","volume":"26","author":"Anil Kothari","year":"2013","journal-title":"Ann Gastroenterol"},{"key":"2025123106151533000_18.12.e269762.10","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1055\/s-2000-638","article-title":"Hemosuccus pancreaticus--a rare cause of gastrointestinal bleeding: diagnosis and interventional radiological therapy","volume":"32","author":"Benz","year":"2000","journal-title":"Endoscopy"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-269762","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T14:15:27Z","timestamp":1767190527000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-269762"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":10,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12,31]]},"published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1136\/bcr-2025-269762"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-269762","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2025,12]]}}}