Gastrointestinal bleeding due to an erosion of the superior mesenteric artery: an exceptional fatal complication of pancreatic pseudocyst

Abstract

The erosion of a pancreatic pseudocyst into an adjacent artery is a rare and highly lethal complication of pancreatitis with reported death rates of 12% to 40% [1]. Despite improvements in the diagnosis and management of pancreatic pseudocysts, the incidence of intracystic hemorrhage ranges from 6% to 17%. In recent reports, investigators have described the successful management of pancreatic pseudoaneurysms with endovascular techniques and have advocated percutaneous angiographic embolization as the preferred treatment modality. An operation should be reserved for actively and hemodynamically unstable patients. We report the case of a 50 year old patient having a cataclysmic upper gastrointestinal bleeding due to an erosion of the superior mesenteric artery by a pancreatic pseudocyst, and discuss contemporary methods in diagnosis and management of the condition.

Keywords

• gastrointestinal bleeding
• superior mesenteric artery
• pancreatic pseudocyst
• acute pancreatitis
• emergency