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.

Axios é a seqüência de xilogravuras produzidas em suporte de mdf com uma única goiva em V que pretende ampliar a reflexão a respeito do corpo humano como temática expressiva, incluindo imagens gravadas e a reflexão teórica a respeito desse processo e a criação do sentido, reconstruindo parte daquilo que o artista precisa dizer a si mesmo para iniciar a aventura de manifestações poéticas por intermédio do diálogo entre a gravura e o observante. / Axios is a sequence of xylographs produced on mdf support with only one V-form gouge; through which we mean to expand the reflection about the human body as an expressive theme, and which includes engraved images and theoretical reflection concerning this process as well as the creation of meaning process; reconstructing, through the dialogue between the engraving and the observer, part of that which the artist needs to say to himself to begin the adventure of poetic manifestation.

Axios é a seqüência de xilogravuras produzidas em suporte de mdf com uma única goiva em V que pretende ampliar a reflexão a respeito do corpo humano como temática expressiva, incluindo imagens gravadas e a reflexão teórica a respeito desse processo e a criação do sentido, reconstruindo parte daquilo que o artista precisa dizer a si mesmo para iniciar a aventura de manifestações poéticas por intermédio do diálogo entre a gravura e o observante. / Axios is a sequence of xylographs produced on mdf support with only one V-form gouge; through which we mean to expand the reflection about the human body as an expressive theme, and which includes engraved images and theoretical reflection concerning this process as well as the creation of meaning process; reconstructing, through the dialogue between the engraving and the observer, part of that which the artist needs to say to himself to begin the adventure of poetic manifestation.