A subcapsular splenic hematoma is a very rare hemorrhagic complication of pancreatitis. We report here on a case of pseudocyst with a large subcapsular splenic hematoma in a 43-year-old man who presented with severe left flank pain for one week. Despite the initial conservative treatment consisting of pain control, bowel rest, intravenous fluids and antibiotics, the pain was not relieved. An abdominal computed tomography (CT) was performed, and it showed a pseudocyst that was increasing in size with a large subcapsular splenic hematoma measuring 6×13 cm compared to the images at admission. Ultrasonography (US)-guided percutaneous drainage was performed without any complications, and splenectomy was avoided. After the discharge, the patient remained asymptomatic for eight months. We suggest that percutaneous drainage of a large subcapsular hematoma complicating pancreatitis might be a useful treatment option in selected patients. (Korean J Gastroenterol 2011;57:258-261)
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