A case of chronic alcoholic pancreatitis accompanied by gastric bleeding derived from the penetration of an aneurysm of the left gastric artery to the stomach

Abstract

A 42-year-old man with alcoholic chronic pancreatitis was admitted complaining of hematoemesis.
Emergency endoscopic examination revealed much coagulated blood in the stomach, but we could not find bleeding spots and the bleeding had stopped. Computed tomography demonstrated massive blood in the stomach and also a pancreatic pseudocyst containing blood. Furthermore, there was an aneurysm of the left gastric artery in the pancreatic pseudocyst. It was suspected that this aneurysm had perforated to the pancreatic pseudocyst, resulting in penetration to the weak portion of the stomach around the lesion the drainage of the pseudocyst via the gastric posterior portion which was done at a previously visited hospital.
The patient underwent embolization by microcapusule, histoacryllipiodol and distal pancreatectomy. Chronic pancreatitis complicated by vascular aneurysms of the small artery is not so rare, but only nine cases of a rupture of an aneurysm of the left gastric artery have been reported in Japan.