Endoscopic cyanoacrylate injection for massive bleeding from a ruptured pseudocyst

Area of Science:

• Gastroenterology
• Vascular Surgery
• Interventional Radiology

Background:

• Arterial bleeding is a severe complication of acute pancreatitis.
• Pancreatic pseudocysts can lead to fistulas, causing hemorrhage.
• Emergent interventions like embolization or surgery are often required.

Observation:

• A patient presented with massive arterial bleeding.
• The bleeding originated from a pseudocyst fistulizing into the stomach.
• This rare presentation posed significant management challenges.

Findings:

• Successful endoscopic management of arterial bleeding from a pseudocyst-gastric fistula.
• Utilized endoscopic injection of cyanoacrylate for hemostasis.
• Achieved complete cessation of bleeding without surgical or endovascular intervention.

Implications:

• Endoscopic cyanoacrylate injection is a viable, minimally invasive treatment option.
• Offers an alternative to surgery or embolization for specific cases of arterial bleeding.
• Highlights the importance of considering endoscopic techniques in managing complex pancreatitis complications.