{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T03:35:38Z","timestamp":1783136138233,"version":"3.54.6"},"reference-count":14,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Investigative Medicine High Impact Case Reports"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:p>Pancreatic pseudocyst is a common complication of pancreatitis. Pseudocysts may require decompression when they become painful, infected, or start compressing surrounding organs. Decompression is achieved by endoscopic cystogastrostomy. Recently, the use of lumen-apposing metal stent (LAMS) for cystogastrostomy has gained popularity due to ease of use and high technical success. LAMS has a wider lumen, which allows for direct endoscopic necrosectomy in the cases of walled-off necrosis. Our patient is a 30-year-old male who presented with massive hematemesis and dizziness. He had a history of chronic alcohol-induced pancreatitis. Three weeks before the presentation, he underwent a cystogastrostomy with LAMS placement to treat a 10-cm walled-off necrosis. Urgent computed tomography (CT) scan did not reveal any acute finding suggestive of bleeding. Esophagogastroduodenoscopy showed blood protruding from the LAMS with a large clot formation. Attempts to stop bleeding were unsuccessful. He underwent CT angiography of the abdomen. CT angiography showed a bleeding pseudoaneurysm (PA) believed to be a complication of the LAMS. Subsequently, multiple coils were placed in the splenic artery near the PA. The patient continued to improve without a further drop in hemoglobin and was eventually discharged. PA formation and subsequent rupture is a rare delayed complication of LAMS. It may lead to massive gastrointestinal bleeding with a high mortality rate. Diagnostic delays have resulted in increased mortality by 60%. In this article, we present a case of massive gastrointestinal bleeding due to a ruptured splenic artery PA presenting as a delayed complication of LAMS.<\/jats:p>","DOI":"10.1177\/2324709620965800","type":"journal-article","created":{"date-parts":[[2020,10,15]],"date-time":"2020-10-15T07:51:03Z","timestamp":1602748263000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Massive Upper Gastrointestinal Bleeding Following LAMS (Lumen-Apposing Metal Stent) Placement"],"prefix":"10.1177","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5306-3916","authenticated-orcid":false,"given":"Bhavesh","family":"Gajjar","sequence":"first","affiliation":[{"name":"East Tennessee State University, Johnson City, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyler","family":"Aasen","sequence":"additional","affiliation":[{"name":"East Tennessee State University, Johnson City, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Puneet","family":"Goenka","sequence":"additional","affiliation":[{"name":"East Tennessee State University, Johnson City, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay","family":"Gayam","sequence":"additional","affiliation":[{"name":"Interfaith Medical Center, Brooklyn, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,10,15]]},"reference":[{"key":"bibr1-2324709620965800","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2015.10.020"},{"key":"bibr2-2324709620965800","doi-asserted-by":"publisher","DOI":"10.1159\/000055829"},{"key":"bibr3-2324709620965800","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1983.01390010035009"},{"key":"bibr4-2324709620965800","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2016.08.014"},{"key":"bibr5-2324709620965800","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v20.i43.16132"},{"key":"bibr6-2324709620965800","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2016-312812"},{"key":"bibr7-2324709620965800","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2017.06.029"},{"key":"bibr8-2324709620965800","doi-asserted-by":"publisher","DOI":"10.1016\/S0741"},{"key":"bibr9-2324709620965800","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2017.05.035"},{"key":"bibr10-2324709620965800","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-006-0209-z"},{"key":"bibr11-2324709620965800","doi-asserted-by":"publisher","DOI":"10.1159\/000492459"},{"key":"bibr12-2324709620965800","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-016-5023-6"},{"key":"bibr13-2324709620965800","doi-asserted-by":"publisher","DOI":"10.4253\/wjge.v9.i9.456"},{"key":"bibr14-2324709620965800","doi-asserted-by":"publisher","DOI":"10.1055\/a-1096-3299"}],"container-title":["Journal of Investigative Medicine High Impact Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2324709620965800","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/2324709620965800","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2324709620965800","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T08:00:53Z","timestamp":1777449653000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/2324709620965800"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1]]},"references-count":14,"alternative-id":["10.1177\/2324709620965800"],"URL":"https:\/\/doi.org\/10.1177\/2324709620965800","relation":{},"ISSN":["2324-7096","2324-7096"],"issn-type":[{"value":"2324-7096","type":"print"},{"value":"2324-7096","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1]]},"article-number":"2324709620965800"}}