Major gastrointestinal hemorrhage associated with pancreatic pseudocyst

Although the pancreas is not a frequent source of major gastrointestinal hemorrhage, bleeding in patients with pancreatitis is not an uncommon complication. In patients with bleeding who are known to have pancreatitis or a pseudocyst, this organ must be considered a possible site of hemorrhage.It is recommended that celiac axis and superior mesenteric artery angiography be performed prior to barium contrast studies.If bleeding is originating from a pancreatic pseudocyst, aggressive surgical intervention should be undertaken. Three cases are described in which prompt operation was successful.Intracystic suture-ligation of the bleeding vessel together with cystogastrostomy was performed in two cases. One case of bleeding from a pseudocyst in the head of the pancreas and involving the gastroduodenal artery was treated by excision of the cyst and head of the pancreas.