Hemosuccus pancreaticus (HP) is characterized by hemorrhage from the pancreatic duct through the major duodenal papilla. It represents the least common cause of upper gastrointestinal bleeding (UGIB), occurring in approximately 1 in 1,500 cases and predominantly affecting men. A 58-yearold woman with a history of recurrent pancreatitis presented with severe epigastric pain, vomiting, and diarrhea. Laboratory tests revealed hyperamylasemia. Imaging indicated acute necrohemorrhagic pancreatitis with peripancreatic fluid collections. Despite interventions including drainage and antibiotic therapy, she developed massive hematemesis and hemodynamic instability. Computed tomography indicated active bleeding in the peripancreatic region, and angiography confirmed a diagnosis of HP. Embolization of the gastroduodenal artery was performed; however, the patient died of multiorgan failure. HP, although rare, should be considered in patients with chronic pancreatitis and intermittent UGIB. Diagnosing HP can be challenging, requiring collaboration between gastroenterologists and interventional radiologists. Early intervention is crucial due to the high mortality rate associated with severe cases.

Hemosuccus pancreaticus (HP) is characterized by hemorrhage from the pancreatic duct through the major duodenal papilla. It represents the least common cause of upper gastrointestinal bleeding (UGIB), occurring in approximately 1 in 1,500 cases and predominantly affecting men. A 58-yearold woman with a history of recurrent pancreatitis presented with severe epigastric pain, vomiting, and diarrhea. Laboratory tests revealed hyperamylasemia. Imaging indicated acute necrohemorrhagic pancreatitis with peripancreatic fluid collections. Despite interventions including drainage and antibiotic therapy, she developed massive hematemesis and hemodynamic instability. Computed tomography indicated active bleeding in the peripancreatic region, and angiography confirmed a diagnosis of HP. Embolization of the gastroduodenal artery was performed; however, the patient died of multiorgan failure. HP, although rare, should be considered in patients with chronic pancreatitis and intermittent UGIB. Diagnosing HP can be challenging, requiring collaboration between gastroenterologists and interventional radiologists. Early intervention is crucial due to the high mortality rate associated with severe cases.

Hemosuccus pancreaticus (HP) is characterized by hemorrhage from the pancreatic duct through the major duodenal papilla. It represents the least common cause of upper gastrointestinal bleeding (UGIB), occurring in approximately 1 in 1,500 cases and predominantly affecting men. A 58-yearold woman with a history of recurrent pancreatitis presented with severe epigastric pain, vomiting, and diarrhea. Laboratory tests revealed hyperamylasemia. Imaging indicated acute necrohemorrhagic pancreatitis with peripancreatic fluid collections. Despite interventions including drainage and antibiotic therapy, she developed massive hematemesis and hemodynamic instability. Computed tomography indicated active bleeding in the peripancreatic region, and angiography confirmed a diagnosis of HP. Embolization of the gastroduodenal artery was performed; however, the patient died of multiorgan failure. HP, although rare, should be considered in patients with chronic pancreatitis and intermittent UGIB. Diagnosing HP can be challenging, requiring collaboration between gastroenterologists and interventional radiologists. Early intervention is crucial due to the high mortality rate associated with severe cases.

ABSTRACT Orthodontic treatments have been described as a risk factor for the development of gingival recessions. This descriptive and cross-sectional study was performed to evaluate the alveolar bone morphotype of the upper and lower anterior of 33 orthodontic treatment of candidate patients. The images were obtained from a high-resolution cone beam computerised tomography. Then, the thickness of the alveolar bone plate of teeth was measured in six levels, recording the presence of dehiscences and fenestrations. A total of 2,334 sites were evaluated. The average thickness of the maxillary alveolar bone at the buccal surface was 0.70, 0.62 and 1.43 mm at the cervical, middle and apical levels, respectively, while in the mandibular teeth it was 0.53, 0.50 and 2.96 mm. At the palatal and lingual surfaces, the bone was thicker than the buccal except at the apical level of the mandible. Most of the examined sites were measured less than 1 mm (n = 1,235, 52.9%), associated with high prevalence of bone dehiscences (57.6%) and fenestrations (33.3%), particularly in skeletal Class III patients. The observed bone morphotype involved a high vulnerability to bone resorption, and the subsequent gingival recession occurrence, face to orthodontic movements.
Alveolar Bone Loss ; Orthodontics