Complex Hemosuccus Pancreaticus from Dual Pseudoaneurysms: A Rare Case of Gastroduodenal and Inferior Pancreaticoduodenal Artery Involvement

Hemosuccus pancreaticus (HP) is a rare yet critical cause of upper gastrointestinal bleeding, often challenging to diagnose due to its intermittent presentation. We present a complex case of HP in a 63-year-old woman with hematemesis and melena caused by dual pseudoaneurysms in the gastroduodenal and inferior pancreaticoduodenal arteries. Contrast-enhanced computed tomography (CT) and upper GI endoscopy confirmed active bleeding from the ampulla of Vater. Successful management was achieved with retrograde coil embolization. This case highlights the diagnostic and therapeutic challenges in HP and emphasizes the necessity of a multidisciplinary approach for managing dual pseudoaneurysms in this uncommon presentation.