Gastroduodenal artery aneurysm presenting as chronic gastrointestinal blood loss.

Gasiroititestinal hemorrhage is common in patients with chronic pancreatitis. The bleeding source is usually the mucosa ofthe stomach and duodenum. Gastroduodenal artery ancurysms in patients with pancreatitis are rare, but frequently present with massive upper intestinal bleeding. We present a case of recurrent occult and overt gastrointestinal bleeding over a t-year period in a patient with a clinically silent pancreatic pseudocyst. The final diagnosis was established by endoscopic visualization of bleeding from the ampulla of Vater. The natural history and the approach to diagnosis and treatment of peripancreatic pseudoaneurysms is reviewed.