Intracystic Hemorrhage From a Splenic Artery Within a Pancreatic Pseudocyst: A Case Report.

Abstract

A pancreatic pseudocyst, typically resulting from acute pancreatitis, is a cystic lesion that lacks a true epithelial layer and can lead to various complications, including hemorrhage, which is most often associated with the splenic artery. Hemorrhage within a pseudocyst is a rare but severe complication, manifesting as intracystic, peritoneal, or gastrointestinal tract bleeding. We present a unique case of a 50-year-old male farmer with a history of acute pancreatitis who developed an intracystic hemorrhage due to ischemia in the splenic artery traversing a pancreatic pseudocyst. The patient was successfully treated with angiographic embolization after presenting with symptoms of gastrointestinal bleeding, hypotension, and abdominal pain. Initial management included conservative monitoring, but upon further complications, intervention became necessary. The patient's postoperative course was uneventful, and follow-up imaging confirmed the resolution of the hemorrhage and stabilization of the pseudocyst. This case underscores the importance of recognizing and promptly treating hemorrhagic pancreatic pseudocysts, particularly those involving visceral vessels. It also highlights the role of angiographic embolization as an effective treatment option. Given the rarity of such cases, our report aims to contribute to the growing body of literature and provide guidance for the management of similar cases in the future. Continued documentation and study of these cases are essential to developing standardized treatment protocols and improving patient outcomes.