A Case of Penetration of the Stomach with a Postoperative Bleeding Pseudocyst of the Pancreas into the Stomach due to a Ruptured Pseudoaneurysm

Abstract

A 75-year-old woman was admitted to the hospital with cancer of the pancreatic tail, and she underwent a distal pancreatectomy and splenectomy. A pseudocyst of the pancreas was occurred as a postoperative complication. On the 28th postoperative day, hematemesis suddenly occurred and an emergency gastrointestinal endoscopic examination showed a lot of coagulation, but no fresh bleeding. Conservative treatment provided temporary improvement, but on the 31st postoperative day hematemesis recurred. Dynamic computed tomography (CT) revealed massive bleeding from the cut end of the splenic artery. An emergency operation was performed to achieve hemostasis. The patient recovered successfully and discharged after treatment of an intractable pancreatofistula. Most cases with hemorrhage from the gastrointestinal tract of pancreatic pseudocysts have a poor prognosis. A case of a pseudocyst of the pancreas resulting in hemorrhage from the stomach is presented here with a review of the literature.