Hemorrhagic pancreatitis

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

Pathology

Hemorrhage can occur in patients with severe necrotizing pancreatitis or as a result of pancreatic pseudoaneurysm rupture when it constitutes a life-threatening emergency.

Etiology

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

  • bleeding pancreatic pseudoaneurysm or peripancreatic pseudoaneurysm: ~60%
  • diffuse bleeding with pancreatic necrosis: ~20%
  • hemorrhagic pancreatic pseudocysts: ~20%

Radiographic features

CT

Acute hemorrhage typically has high attenuation on unenhanced CT scans. The attenuation value then decreases as the hematoma ages through time 5.

MRI

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

  • T1: high-signal intensity methemoglobin 
  • T2: low-signal intensity hemosiderin rim

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

Pancreatic pathology
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Article information

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

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Cases and figures

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  • Case 2
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