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Direct fistula between the splenic artery and the pancreatic duct is briefly reviewed. The literature indicates that such a fistula is almost always due to a pancreatic artery aneurysm. Because of diagnostic difficulties, a variety of operations have been performed on these patients prior to arriving at the correct diagnosis. A patient's history of direct fistula between the splenic artery and the pancreatic duct, causing recurrent haemorrhage and eventual death from massive blood loss, is described. Unlike other reported cases, this was not associated with an angiographically demonstrable aneurysm of the splenic artery. Treatment by distal pancreatectomy or radiologically guided pancreatic artery embolization is discussed.