Pancreatic cyst complicated by major arterial erosion and gastrointestinal haemorrhage.

Uncommonly, pancreatic cysts are complicated by the erosion of certain adjacent arteries and serious gastrointestinal haemorrhage. This diagnosis should be entertained in any patient with chronic pancreatitis who presents with unexplained gastrointestinal blood loss, whether acute or chronic, a pulsatile mass in the epigastrium, and an associated bruit. Selective caeliac axis angiography may not only confirm the diagnosis, but provide precise anatomical information as a guide to the surgeon in planning treatment. The surgical treatment of choice is transcystic ligation of the bleeding vessel, followed by internal cyst drainage.