Three cases of massive bleeding from pancreatic pseudocysts

BackgroundIntracystic bleeding is an infrequent but potentially lethal complication of pancreatic pseudocyst. Early preoperative diagnosis is an important aspect of effective management.Case outlinesThree patients presented with bleeding into a pancreatic pseudocyst. One was managed by intracystic ligation and external drainage, one was managed with postoperative angiographic embolisation and the third patient underwent angiographic embolisation as definitive treatment.DiscussionMassive bleeding from a pseudoaneurysm associated with pseudocyst of the pancreas carries a high mortality and morbidity rate. A high index of suspicion for patients with suggestive clinical signs and symptoms plus careful evaluation on a thin-sliced contrast-enhanced CT scan with early and delayed films corroborated by selective angiography leads to better management.