Rupture of the gastric serosa due to a pancreatic pseudocyst as a cause of hemoperitoneum

Abstract

Pancreatic pseudocysts, as one of the many complications of pancreatitis, are usually asymptomatic and are not commonly considered in the differential diagnosis of acute abdominal events.

A pancreatic pseudocyst with its aggressive juices tends to damage nearby organs, leading to their fibrotic changes and low-quality healing. Such organ changes are more prone to follow up complications. The most dangerous bleeding source in pancreatic pseudocyst patients is splenic artery aneurysm, often solved by endovascular interventions. In other cases, mainly in haemodynamic stable patients, maximum conservative approach is preferred.

In this case report, we present hemorrhage into a pancreatic pseudocyst in a gastric serosa rupture as a rare cause of sudden-onset abdominal pain and hemoperitoneum, which led to urgent surgical exploration and necessitated a more extensive resection of organs damaged during the rupture of the pancreatic pseudocyst.