Abstract
We report the case of a man who developed life-threatening massive gastric hemorrhage 3 months after undergoing cystogastrostomy for a pancreatic pseudocyst. After cystogastrostomy, the pancreatic pseudocyst became remarkably reduced in size, having the appearance of a shallow ulcer by barium study. However, tarry stools and hematemesis developed 3 months later, 6 days after which sudden massive hematemesis and melena occurred with severe hypotension. At emergency operation, a large artery at the bottom of the reduced cyst wall was found to have ruptured and hemostasis was achieved by suture ligation. The splenic artery was suspected as the bleeding point because a 95% abrupt stenosis was seen on angiography-performed the next day. Thus, the risk of hemorrhage occurring after internal drainage of a pancreatic pseudocyst even in the late postoperative period should always be borne in mind.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Huizinga WKJ, Kalideen JM, Bryer JV, Bell PSH, Baker LW (1984) Control of major haemorrhage associated with pancreatic pseudocysts by transcatheter arterial embolization. Br J Surg 71:133–136
Sbroschi RD, Anderson MC (1984) Erosion of adjacent organs by pancreatic pseudocysts. Am J Surg 50:85–90
Belli G, Romano G, D'Alessandro V, Santangelo ML (1989) Severe hemorrhage associated with pancreatic pseudocysts: reports of two cases. Int J Pancreatol 4:455–460
Simpson A, Srivastava VK (1973) Pseudocyst of the pancreas. Br J Surg 60:45–49
Brown RA, Immelman EJ, Harries-Jones EP (1985) Pancreatic duct hemorrhage. Br J Surg 72:223–224
Sankaran S, Walt AJ (1975) The natural and unnatural history of pancreatic pseudocysts. Br J Surg 62:37–44
Frey CF (1978) Pancreatic pseudocyst — operative strategy. Ann Surg 188:652–662
Greenstein A, De Maio E, Nabseth DC (1971) Acute hemorrhage associated with pancreatic pseudocysts. Surgery 69:56–62
Donnely PK, Lavelle J, Carr-Locke D (1990) Massive haemorrhage following endoscopic transgastric drainage of pseudocyst. Br J Surg 77:758–759
Gholson CF, Williams C, Patterson CR (1989) Bloody drainage following endoscopic retrograde pancreatography as a presentation of a pseudoaneurysm-containing pseudocyst. Gastrointest Endosc 35:111–112
Saisho H, Yamaguchi T (1993) Natural history and management of pancreatic pseudocysts — medical aspects (in Japanese). Kan Tan Sui 26:961–964
Stabile BE, Wison SE, Debas HT (1983) Reduced mortality from bleeding pseudocysts and pseudoaneurysms caused by pancreatitis. Arch Surg 118:45–51
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Ikoma, A., Tanaka, K., Ishibe, R. et al. Late massive hemorrhage following cystogastrostomy for pancreatic pseudocyst: Report of a case. Surg Today 25, 79–82 (1995). https://doi.org/10.1007/BF00309393
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00309393