Discussion: Hemosuccus pancreaticus is defined as bleeding expelled from the pancreatic duct into the duodenum at the site of the ampulla of Vater. It is a rare cause of upper gastrointestinal bleeding (1/1500). The biggest risk factor for hemosuccus pancreaticus is chronic pancreatitis, in which the inflammation results in the formation of aneurysms or pseudoaneurysms, which can rupture. Other risk factors include trauma, pancreatic tumor, and vascular malformation. HP is a diagnostic challenge because it presents as an obscure upper gastrointestinal bleed. Endoscopy is necessary to rule out other etiologies of bleeding, but does not always help determine an etiology. Ultimately, angiography is the gold standard for diagnosis. Surgery and angiographic embolization are the recommended treatment options. Left untreated, mortality can be as high as 90%. Transcatheter embolization of the bleeding artery is attempted first, with success rates of 80-100%. If bleeding cannot be stopped, then distal pancreatectomy is performed.

Conclusion: Our case demonstrates that hemosuccus pancreaticus should be on the differential for the etiology of a upper gastrointestinal bleed in a patient with a history of pancreatic disease.