{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T16:19:58Z","timestamp":1783354798218,"version":"3.54.6"},"reference-count":6,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:00:00Z","timestamp":1778112000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:00:00Z","timestamp":1778112000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Rep Gastroenterol"],"abstract":"<jats:p>Introduction: Upper gastrointestinal bleeding (UGIB) is an uncommon complication of pancreatitis and may be challenging to diagnose when bleeding is intermittent and routine investigations are inconclusive. We report a case of intermittent UGIB associated with a hemorrhagic pancreatic pseudocyst and transient cystoduodenal fistula. Case Presentation: A 29-year-old woman with biliary pancreatitis complicated by necrotizing pancreatitis and recurrent pancreatic collections presented with recurrent pancreatitis and intermittent UGIB. Imaging revealed a hemorrhagic pancreatic pseudocyst. During hospitalization, she experienced three discrete bleeding episodes over 10 days, including hematemesis, coffee ground emesis, and maroon-colored stools, with a hemoglobin nadir of 7.5 g\/dL, requiring transfusion. Esophagogastroduodenoscopy revealed a duodenal bulb mucosal defect consistent with a cyst-duodenal fistula, which healed spontaneously. Repeated computed tomography angiography revealed no active bleeding or evidence of a pseudoaneurysm. Subsequent evaluation revealed pancreatic duct disruption with contrast leakage into a persistent pancreatic collection. Pancreatic duct stenting was performed, after which no further bleeding occurred. Conclusion: This case highlights transient cyst-duodenal fistulization as an underrecognized mechanism of intermittent UGIB in complicated pancreatitis and emphasizes that negative angiography does not exclude the pancreatic source of bleeding.<\/jats:p>","DOI":"10.1159\/000552379","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T16:01:05Z","timestamp":1778169665000},"page":"190-195","source":"Crossref","is-referenced-by-count":0,"title":["Intermittent Upper Gastrointestinal Bleeding Associated with a Hemorrhagic Pancreatic Pseudocyst and Transient Cyst-Duodenal Fistula: A Case Report"],"prefix":"10.1159","volume":"20","author":[{"given":"Mohamed H.","family":"Fadul","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8468-3499","authenticated-orcid":false,"given":"Yousef","family":"Yahia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed S.","family":"Elmahadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Girisha","family":"Balaraju","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,5,7]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjms.2023.03.027"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.15279\/kpba.2014.19.2.111"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2020.03.020"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.4240\/wjgs.v16.i7.1986"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.12933"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2012-302779"}],"container-title":["Case Reports in Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000552379","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T16:03:38Z","timestamp":1783353818000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000552379"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,7]]},"references-count":6,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,1]]}},"URL":"https:\/\/doi.org\/10.1159\/000552379","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.32197476","asserted-by":"subject"}]},"ISSN":["1662-0631"],"issn-type":[{"value":"1662-0631","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,7]]}}}