Massive Gastric Bleed 20 Years After Splenopneumopexy

Splenopneumopexy is an anastomosis performed for patients with portal hypertension secondary to veno-occlusive disease of the portal, splenic, or mesenteric veins. We present a case of an adult gentleman who presented with melena and was found to have pseudoaneurysm almost 20 years after his procedure. We also describe the clinical, laboratory, endoscopic, and radiological workup conducted to diagnose and manage gastric bleeding in this rare complication.