Gastric bleeding from a penetrating pancreatic pseudocyst with pseudoaneurysm of the splenic artery.

The successful management of gastric bleeding from a pseudocyst with a pseudoaneurysm of the splenic artery is reported here. A 62-year-old male patient was referred to our hospital with a complaint of hematomesis. On a computed tomography and an abdominal angiography, it was evident that he was actively bleeding from a splenic pseudoaneurysm caused by a pancreatic pseudocyst. A transcathetheral arterial embolization (TAE) was performed on the splenic pseudoaneurysm to control bleeding. After the TAE, we resected the pancreatic pseudocyst by distal pancreatectomy with partial gastrectomy. Gastrointestinal bleeding from a pseudoaneurysm caused by a pancreatic pseudocyst is a rare, but sometimes lethal, complication. As only conservative therapy or TAE often results in lethal re-bleeding, we propose to perform elective surgery after TAE.