Massive gastric bleeding - perforation of pancreatic pseudocyst into the stomach: A case report and review of literature

BACKGROUND: Pancreatic pseudocyst may cause serious gastrointestinal complications including necrosis, infection, and perforation of the gastrointestinal tract wall, but massive gastric bleeding is very rare. CASE: We report a rare case of a 49-year-old man with life-threatening gastric bleeding from a pseudoaneurysm of the splenic artery perforating the stomach induced by pancreatic pseudocyst. During hospitalization, gastroscopy revealed a bare blood vessel in an ulcer-like depression of the greater gastric curvature, and computed tomography scan confirmed a pancreatic pseudocyst invading part of the spleen and gastric wall of the greater curvature. Arteriography showed that the bare blood vessel originated from a pseudoaneurysm of the splenic artery. The bleeding was controlled by the trans-arterial embolization, the patient’s recovery was rapid and uneventful. CONCLUSION: Massive gastrointestinal bleeding could be a rare complication of pancreatic pseudo aneurysm.