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 pancreatic pseudoaneurysm rupture 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 the 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
Tag: cases
Synonyms or Alternate Spellings:
  • Haemorrhagic complicating pancreatitis
  • Pancreatitis complicated by haemorrhage
  • Hemorrhagic pancreatitis
  • Pancreatitis complicated by hemorrhage

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