Hemorrhagic pancreatitis

Last revised by Jeremy Jones on 20 Sep 2021

Hemorrhagic pancreatitis is characterized by bleeding within or around the pancreas, and is usually considered a late sequela of acute pancreatitis.


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


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


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


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.

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Cases and figures

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