Ruptured pancreatic pseudocysts: diagnosis by endoscopy. Report of 3 cases

Area of Science:

• Gastroenterology
• Endocrinology
• Surgical Gastroenterology

Background:

• Pancreatic pseudocysts are fluid collections that can develop after pancreatitis.
• Spontaneous perforation into adjacent organs is a rare but serious complication.
• Upper gastrointestinal (GI) bleeding is an uncommon presenting symptom of this condition.

Observation:

• Three cases of spontaneous pancreatic pseudocyst perforation into the stomach were reported.
• The primary presenting symptom in all cases was acute upper GI bleeding.
• Endoscopic examination revealed a hemorrhagic protrusion into the stomach, resembling a surgical anastomosis after full perforation.

Findings:

• High amylase concentration in aspirates provided further diagnostic evidence.
• All three patients survived the event.
• Two patients recovered without requiring surgical intervention.

Implications:

• This presentation highlights a rare but treatable cause of acute upper GI bleeding.
• Endoscopic evaluation is crucial for diagnosing spontaneous pseudocyst perforation.
• Conservative management may be successful in select cases, avoiding surgical morbidity.