Massive upper gastrointestinal haemorrhage due to direct visceral erosion of splenic artery aneurysm.

Six male patients (age group: 30-60 years) with aneurysm of the splenic artery presented with massive upper gastrointestinal tract hemorrhage. Five patients presented with hematemesis and one with melena. Chronic pancreatitis was noted in all the patients, four of whom were chronic alcoholics. Endoscopy was not useful in diagnosis. Bleeding through the Ampulla of Vater was seen in the patient with melena. Angiography was diagnostic in all. Pancreatic resection including the aneurysm(2), and bipolar ligation with underrunning of the aneurysm (3) were the operative procedures. Distal pancreatectomy with pancreatogastrostomy was carried out in the patient with hemosuccus pancreaticus. If endoscopy is inconclusive, angiography and early intervention is recommended to reduce the high mortality associated with conservative management.

Gastric lipoma presenting as obstruction and hematemesis.

A rare case of gastric lipoma presented to us with hematemesis and symptoms of obstruction. On oesophagoduodenoscopy, a mass projecting in the lumen of stomach was found. Barium meal examination revealed a mass in the antral region suggestive of malignancy. The diagnosis of lipoma was suspected only after exploration. It was confirmed following incision through the serosa. The lipoma was enucleated without any damage to mucosa.