LATE MASSIVE HEMORRHAGE FOLLOWING CYSTOGASTROSTOMY FOR PANCREATIC PSEUDOCYST - REPORT OF A CASE

We report the case of a man who developed life-threatening massive gas tric hemorrhage 3 months after undergoing cystogastrostomy for a pancr eatic pseudocyst. After cystogastrostomy, the pancreatic pseudocyst be came remarkably reduced in size, having the appearance of a shallow ul cer by barium study. However, tarry stools and hematemesis developed 3 months later, 6 days after which sudden massive hematemesis and melen a occurred with severe hypotension. At emergency operation, a large ar tery at the bottom of the reduced cyst wall was found to have ruptured and hemostasis was achieved by suture ligation. The splenic artery wa s suspected as the bleeding point because a 95% abrupt stenosis was se en 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 he borne in mind.