Spontaneous pancreatic bleeding

A condition of massive pancreatic hemorrhage without relation to injury, inflammation, or aneurysm is described. Seven patients treated between 1972 and 2001 with spontaneous pancreatic bleeding were reviewed. Follow-up examinations were performed in 1999. At the time of presentation, all patients had abdominal pain, upper abdominal tenderness, and shock, findings that led laparotomy, where the diagnosis was made. The treatment was suture ligation in every case. The postoperative course was uncomplicated for five of the seven patients. The other two patients died. In conclusion, spontaneous pancreatic bleeding is rare and, because of shock and the need for urgent surgery, the diagnosis cannot be made preoperatively. The immediate mortality seems to be high.