Haemorrhagic pancreatitis

Haemorrhagic pancreatitis is a possible uncommon complication that can occur with pancreatitis and is characterised by bleeding within or around the pancreas. It is usually considered a late sequela of acute pancreatitis.

Pathology

Haemorrhage can occur in patients with severe necrotising pancreatitis or as a result of the rupture of a pancreatic pseudoaneurysm, when it constitutes a life-threatening emergency.

Aetiology

According to one study, the usual causes of haemorrhage were 2:

  • bleeding pancreatic pseudoaneurysm / peripancreatic pseudoaneurysm: ~60%
  • diffuse bleeding with pancreatic necrosis: ~20%
  • haemorrhagic pancreatic pseudocysts: ~20%

Radiographic features

CT

Acute haemorrhage typically has high attenuation on unenhanced CT scans. The attenuation value then decreases as a haematoma ages through time 5.

MRI

Haemorrhagic fluid collections are more evident on MRI than CT due to the following reasons 1:

  • T1: high-signal intensity methaemoglobin 
  • T2: low-signal intensity haemosiderin rim

Signal abnormalities due to haemorrhage remain visible longer on MRI than on CT.

Pancreatic pathology
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Article information

rID: 17667
Section: Pathology
Tag: cases
Synonyms or Alternate Spellings:
  • Haemorrhagic complicating pancreatitis
  • Pancreatitis complicated by haemorrhage
  • Hemorrhagic pancreatitis
  • Pancreatitis complicated by hemorrhage

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