Abstract
We report a case of a patient presenting with melena and dysphagia. His gastroscopy revealed an oesophageal mass and active duodenal papillary haemorrhage. Subsequent endoscopic retrograde cholangiopancreatography (ERCP) confirmed the presence of a haemorrhagic mediastinal pancreatic pseudocyst (MPP). Due to severe alcohol withdrawal syndrome, the patient declined surgical intervention. Conservative management and pancreatic tube placement under ERCP were performed, resulting in clinical stabilization. Follow-up imaging 2 months later demonstrated partial remission of the MPP. We further review the clinical characteristics and contemporary management strategies for MPP.