Introduction: Visceral artery aneurysms are a rare clinical entity with life-threatening complications such as rupture, associated with high mortality.
Case Report: A 50-year-old male presented with a five weeks history of persistent epigastric pain associated with indigestion, weight loss and melena. Ultrasonography showed a mass in the region of pancreatic head suggestive of a pseudoaneurysm. Computed tomography scan confirmed a large pseudoaneurysm supplied by superior pancreaticoduodenal artery exerting direct pressure over the head of the pancreas and second part of the duodenum. An explorative laparotomy performed and aneurysmal dilatation of superior pancreaticoduodenal artery complicated with fistulation into common bile duct and duodenum identified and repaired.
Conclusion: High index of suspicion and timely intervention helps in optimal outcome.

Keywords: Duodenum, Fistulation, Pseudoaneurysm, Superior pancreaticoduodenal artery