Aneurisma de artéria gastroduodenal submetido a tratamento endovascular: relato de caso

Abstract

Resumo O aneurisma de artéria gastroduodenal é uma doença de baixa incidência que se manifesta de forma inespecífica na maioria das vezes, o que dificulta o diagnóstico inicial. Nos casos sintomáticos, pode ocorrer dor abdominal, além de hemorragia secundária à sua rotura. Nos casos de rotura aneurismática, o prognóstico é desfavorável, atingindo 40% de mortalidade. Assim, devem-se empregar os recursos necessários para o diagnóstico e intervenção terapêutica precoce. Embora o tratamento cirúrgico aberto seja uma opção, nos últimos anos, tem havido uma maior tendência ao tratamento endovascular. Relata-se um caso raro de paciente jovem portador de aneurisma de artéria gastroduodenal tratado com sucesso por meio da terapia endovascular.

Endovascular Coil Embolization of an Enlarging Gastroduodenal Artery Aneurysm

“…1 Endovascular approaches are efficient, minimally invasive, and have lower risks of complication and reoperation. 5,8 Open surgical intervention of non-ruptured GDA aneurysm is feasible, although the perioperative morbidity and mortality rate for surgical treatment stands at 9.4%. 3 Mortality for open repair of ruptured GDA aneurysm, however, nears 30%.…”

“…2 Only 7.5% of GDA aneurysms present as asymptomatic, while 46% of patients manifest with nonspecific abdominal pain. 2,5 Mortality rate with GDA aneurysm rupture is about 40% and depends on factors including anatomical site of rupture, speed of blood loss, and size of aneurysm. 2 Non-specific GDA aneurysm symptoms include vomiting, diarrhea, or jaundice secondary to compressive hematoma or external pressure by the aneurysm.…”

“…1 Endovascular approaches are efficient, minimally invasive, and have lower risks of complication and reoperation. 5,8…”

Characteristics and Trends in Median Arcuate Ligament Syndrome (MALS) Associated Visceral Artery Aneurysms: A Systematic Descriptive Review of the Literature

“…Open surgical approach has been reserved to cases with complex anatomy, or significant haemodynamic compromise. 6,8 Perioperative morbidity and mortality for open repair of non-ruptured PDAAs and GDAAs can be up to 9.4% and up to 30% for cases presenting with rupture. 6 Rather than seeking to establish causative links between aneurysm diameter and rupture risk, which is not possible through literature analysis alone, our goal was to qualitatively summarise trends that could inform management guidelines and future research directions.…”

“…Open surgical approach has been reserved to cases with complex anatomy, or significant haemodynamic compromise. 6,8 Perioperative morbidity and mortality for open repair of non-ruptured PDAAs and GDAAs can be up to 9.4% and up to 30% for cases presenting with rupture. 6…”