Splenic artery--pancreatic duct fistula

The difficulties of diagnosis are detailed in a patient presenting with unexplained recurrent severe rectal bleeding due to a fistula between the splenic artery and the pancreatic duct. A review of the condition is presented together with a description of the proposed aetiological factors. The importance of angiographic assessment in the diagnosis and subsequent management of bleeding unexplained by conventional investigations in emphasized. Resection of the aneurysm with distal pancreatectomy and splenectomy is curative.