Rare Causes of Gastrointestinal Bleeding: Focus on Pancreatic Pathology and Visceral Artery Aneurysms.

Beside the common situations of upper gastrointestinal bleeding (GIB) managed by endoscopy, there are clinical situations when the endoscopic approach is limited by the amount of blood, the hemodynamic instability, the intermittent nature of bleeding and a proper diagnosis and treatment requires radiological interventional methods and even surgery. The pancreatic pathology is rarely considered as a possible cause for patients that presents in emergencies with GIB. The rupture of visceral artery aneurysms (VAAs), without underlying pancreatic pathology, should also be regarded in the differential diagnosis of GIB. Even the natural history of VAAs is not well understood, there is a potential risk of bleeding in the gastrointestinal tract, peritoneal cavity and retroperitoneal space, that can result in death. In this paper, we aim to review the rare causes of GIB focusing on pancreatic pathology and VAAs, unrevealed by the underlying pathology and presenting in the emergency department with bleeding symptoms and signs.