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Case Reports in Surgery
Volume 2015, Article ID 981860, 4 pages
http://dx.doi.org/10.1155/2015/981860
Case Report

Pancreatic Pseudocyst with Splenic Artery Erosion, Retroperitoneal and Splenic Hematoma

1Surgical Clinic 4, M5 Department, University of Medicine and Pharmacy of Tirgu-Mures, 540141 Tirgu-Mures, Romania
2Gastroenterology Clinic/Medical I, M3 Department, University of Medicine and Pharmacy of Tirgu-Mures, 540136 Tirgu-Mures, Romania
3Gastroenterology Clinic/Medical VII, M3 Department, University of Medicine and Pharmacy of Tirgu-Mures, 540141 Tirgu-Mures, Romania

Received 21 October 2015; Accepted 1 December 2015

Academic Editor: Fernando Turégano

Copyright © 2015 Petre V. H. Botianu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The erosion of the peripancreatic vascular structures is a rare but life-endangering complication of pancreatic diseases. We report a female patient with a multicompartmentalized pancreatic pseudocyst that eroded the splenic artery resulting in a retroperitoneal and splenic hematoma with hemodynamic instability which required emergency laparotomy with splenectomy, partial cystectomy, ligation of the splenic artery at the level of the vascular erosion, cholecystectomy (lithiasis), and multiple drainage. The postoperative course was difficult (elevated level of platelets, pancreatic fistula) but eventually favourable, with no abdominal complaints and no recurrence at 2-year follow-up. The case shows that the pancreatic pseudocysts may present with acute hemorrhagic complications with life-endangering potential and significant postoperative morbidity.