Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 16, 2021; 9(2): 389-395
Published online Jan 16, 2021. doi: 10.12998/wjcc.v9.i2.389
Massive gastric bleeding - perforation of pancreatic pseudocyst into the stomach: A case report and review of literature
Zhe Jin, Yi-Wei Xiang, Qiu-Shi Liao, Xiao-Xu Yang, Hui-Chao Wu, Bi-Guang Tuo, Rui Xie
Zhe Jin, Yi-Wei Xiang, Qiu-Shi Liao, Xiao-Xu Yang, Hui-Chao Wu, Bi-Guang Tuo, Rui Xie, Department of Gastroenterology, Affiliated Hospital of Zunyi Medical University, Zunyi 563003, Guizhou Province, China
Author contributions: Jin Z and Xiang YW contributed equally to this article; Jin Z and Xiang YW wrote the manuscript; Jin Z, Xiang YW, Liao QS, and Yang XX managed the patients and collected the data; Xie R and Wu HC conducted the pathological examination; Xie R and Tuo BG revised and finalized the manuscript; All authors read and approved the final manuscript.
Supported by The National Natural Science Foundation of China, No. 81660412 (to Rui Xie).
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Rui Xie, MD, PhD, Chief Doctor, Senior Researcher, Department of Gastroenterology, Affiliated Hospital of Zunyi Medical University, No. 149 Dalian Road, Huichuan District, Zunyi 563003, Guizhou Province, China. xr19841029@aliyun.com
Received: June 27, 2020
Peer-review started: June 27, 2020
First decision: July 28, 2020
Revised: August 11, 2020
Accepted: November 21, 2020
Article in press: November 21, 2020
Published online: January 16, 2021
Abstract
BACKGROUND

Pancreatic pseudocyst may cause serious gastrointestinal complications including necrosis, infection, and perforation of the gastrointestinal tract wall, but massive gastric bleeding is very rare.

CASE

We report a rare case of a 49-year-old man with life-threatening gastric bleeding from a pseudoaneurysm of the splenic artery perforating the stomach induced by pancreatic pseudocyst. During hospitalization, gastroscopy revealed a bare blood vessel in an ulcer-like depression of the greater gastric curvature, and computed tomography scan confirmed a pancreatic pseudocyst invading part of the spleen and gastric wall of the greater curvature. Arteriography showed that the bare blood vessel originated from a pseudoaneurysm of the splenic artery. The bleeding was controlled by the trans-arterial embolization, the patient’s recovery was rapid and uneventful.

CONCLUSION

Massive gastrointestinal bleeding could be a rare complication of pancreatic pseudo aneurysm.

Keywords: Gastric bleeding, Pseudoaneurysm of the arteria lienalis, Pancreatic pseudocyst, Trans-arterial embolization, Case report

Core Tip: Massive hemorrhage of the gastrointestinal tract is an infrequent complication of the pancreatic pseudocyst and pseudoaneurysm. We present herein, a novel case of a patient with life-threatening gastric bleeding from a pseudoaneurysm of the splenic artery as a complication of pancreatic pseudocyst perforating into the stomach, with trans-arterial embolization as a potential therapeutic modality for achieving hemostasis.