Pancreatic retention cyst secondary to chronic pancreatitis. A cause of hemobilia.

We describe a 47-year-old male with chronic calcific pancreatitis who had a four-year history of occult gastrointestinal bleeding with three prior hospitalizations. At endoscopy on the fourth admission, hemobilia was identified. Arteriography showed a 3-cm-diameter dye blush in the head of the pancreas. A retention cyst had eroded into an adjacent artery, causing bleeding. A stone at the ampulla of Vater apparently served as a ball valve to prevent massive hemorrhage. We discuss the pathogenesis of hemobilia in chronic pancreatitis and suggested therapy.