Successfully treated life‐threatening upper gastrointestinal bleeding from fistula between gastroduodenal artery pseudoaneurysm and duodenum

Abstract

Case: An 85-year-old man was admitted to the hospital, underwent laparotomy, and was diagnosed with diffuse peritonitis due to perforation of gastric ulcer. Omental patch repair was carried out. After surgery, he suddenly vomited blood and manifested hypovolemic shock. An emergency upper gastrointestinal endoscopy was carried out immediately. However, the bleeding source was not visible. Dynamic-enhanced abdominal computed tomography showed a pseudoaneurysm of the gastroduodenal artery-communicating duodenal lumen with extravasation. Next, the patient underwent angiography for embolization. However, selective arterial embolization was not successful.Outcome: Finally, duodenotomy was carried out. The fistula between the pseudoaneurysm and duodenal lumen was directly ligated.An aneurysm could be clearly identified by previous findings. Conclusions:Gastroduodenal artery aneurysms are very uncommon but possibly lethal if they rupture. This life-threatening condition requires rapid diagnosis and treatment. Minimally invasive treatment is the preferred therapy for gastroduodenal artery aneurysm; however, acute care surgery should be considered without hesitation when conditions are critical.

A Rare Case of Gastroduodenal Artery Aneurysm Rupture with Perforated Duodenal Ulcer: A Case Report

“…Minimally invasive treatment is preferred for gastroduodenal artery aneurysms, but acute care surgery should be considered when conditions are critical [16]. This is supported by a successful case report of surgical repair of a true gastroduodenal artery aneurysm in a patient with liver cirrhosis [17]. The rupture of a gastro-duodenal artery aneurysm is a serious and potentially fatal condition that requires prompt diagnosis and decisive action.…”

Endovascular Treatment of Giant Gastroduodenal Artery Pseudoaneurysm in Chronic Pancreatitis

“…Публикации о гигантских (более 5 см) псевдо-аневризмах (ПА) гастродуоденальной арте рии (ГДА) ограничиваются небольшими сериями наблюдений, которые показывают сложность выбо ра эффективного метода лечения [1][2][3][4][5][6]. Приводим наше наблюдение.…”