Massive gastrointestinal bleeding and perforation of a duodenal diverticulum with coexisting pancreatitis.

A case of perforation and bleeding from a diverticulum of the second portion of the duodenum in a patient with recurrent pancreatitis is presented. Upper gastrointestinal roentgenogram revealed an abnormal tract and retroperitoneal air arising from the diverticulum. The fistulous tract communicated with pancreas. Bleeding was due to erosion of the wall of the pancreaticoduodenal artery. Extensive bleeding should suggest involvement of blood vessel.