Three cases of massive bleeding from pancreatic pseudocysts.

BACKGROUND: Intracystic bleeding is an infrequent but potentially lethal complication of pancreatic pseudocyst. Early preoperative diagnosis is an important aspect of effective management. CASE OUTLINES: Three patients presented with bleeding into a pancreatic pseudocyst. One was managed by intracystic ligation and external drainage, one was managed with postoperative angiographic embolisation and the third patient underwent angiographic embolisation as definitive treatment. DISCUSSION: Massive bleeding from a pseudoaneurysm associated with pseudocyst of the pancreas carries a high mortality and morbidity rate. A high index of suspicion for patients with suggestive clinical signs and symptoms plus careful evaluation on a thin-sliced contrast-enhanced CT scan with early and delayed films corroborated by selective angiography leads to better management.