RUPTURED PSEUDOANEURYSM OF THE SPLENIC AR TERY, A COMPLICATION OF CHRONIC-PANCREATITIS

History and findings: A pale looking 33-year-old man with a history of perforated gastric ulcer and pancreatitis with surgically drained pse udocyst was admitted because of painless anal bleeding. Heart rate was 100/min, blood pressure 90/60 mm Hg. Investigations: Haemoglobin conc entration (6.3 g/dl) and RBC count (2.4 mill./mu l) indicated anaemia due to bleeding. Sonography and computed tomography demonstrated chron ic calcifying pancreatitis and thrombosis of splenic and mesenteric ve ins. There were grade 1 oesophageal varices on endoscopy. The source o f bleeding was found by coloscopy to be a submucous pulsating tumour i n the region of the left flexure, which on angiography was an aneurysm of the splenic artery. Treatment and course: The pseudoaneurysm of th e splenic artery, which had perforated into the colon, was resected to gether with a partial pancreas excision and splenectomy. There were no complications and the patient was discharged symptom-free after 15 da ys, and there had been no further bleeding 6 months later. Conclusion: Pseudoaneurysm of a visceral artery is a rare, but life-threatening, complication of pancreatitis. Treatment options are operation and/or i nterventional catheter embolisation.