Case Report: PDF OnlyGastric Necrosis and Perforation as a Severe Complication of Pancreatic PseudocystHsu, Chia-Yanga, d; Lee, Kuei-Chuana; Chan, Che-Changa, c, *; Lee, Fa-Yauhb, c; Lin, Han-Chieha, c Author Information aDivision of Gastroenterology, Taipei Veterans General Hospital, Taiwan, R.O.C. bDivision of General Medicine, Department of Medicine, Taipei Veterans General Hospital, Taiwan, R.O.C. cDivision of National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C. dDivision of Gastroenterology, Department of Medicine, National Yang-Ming University Hospital, Yilan, Taiwan, R.O.C. *Correspondence to: Dr Che-Chang Chan, Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan, R.O.C. E-mail: [email protected] Received: April 27, 2009; • Accepted: October 12, 2009. Journal of the Chinese Medical Association: November 2009 - Volume 72 - Issue 11 - p 603-606 doi: 10.1016/S1726-4901(09)70437-X Metrics Abstract Patients with acute pancreatitis may present with stress-related gastrointestinal mucosal lesions. But severe gastrointestinal complications such as gastric perforation are very rare. Here, we report a 40-year-old man who was admitted due to acute pancreatitis and pseudocyst formation. During hospitalization, panendoscopic examination found multiple scattered stress ulcers over the gastric antrum and a large ulcerative area with suspicious malignant features at the body and fundus. The patient received surgical intervention due to worsening of his clinical condition. Postoperative findings showed a perforation of the gastric wall at the region in contact with the pseudocyst, and microscopic examination found diffuse ischemia and necrosis with intravascular thrombus and emboli in gastric vessels. We suggest keeping in mind that pancreatic pseudocyst may cause serious gastrointestinal complications including massive necrosis and perforation of the gastric wall. © 2009 by Lippincott Williams & Wilkins, Inc.