Bleeding caused by gastroduodenal artery pseudoaneurysm in a patient with an infected pancreatic pseudocyst

We report a 52 year old man with a pancreatic pseudocyst, that was admitted with severe abdominal pain, severe vomiting, fever and malaise. The clinical picture as considered secondary to a pseudocyst infection and the patient was operated, draining the infected cyst performing a necrosectomy and pancreatocystojejunostomy. Forty eight hours after the operation, an ostomy bleeding was detected. A upper mesenteric artery angiography showed two pseudoaneurysms in the gastroduodenal artery, that were embolized. Bleeding stopped initially, but seven days later, it reappeard. The patient was subjected to an emergency pancreatoduodenectomy. Postoperative evolution was uneventful and the patient was discharged two weeks later. Spontaneous bleeding of pseudoaneuroysms secondary to chronic pancreatitis is a complication with a 15 to 40% mortality that must be bore in mind (Rev Med Chile 2001; 129: 81-85).