A case of pancreaticoduodenal artery aneurysm causing pancreatic pseudotumour and duodenal obstruction

Abstract

This case report describes a ruptured pancreaticoduodenal artery aneurysm (PDAA) causing pancreatic pseudotumour and duodenal obstruction. A 59-year-old man was referred to our hospital with a chief complaint of frequent vomiting without abdominal pain. Because a mass lesion 10 cm in diameter was palpated in the right para-umbilical region and found in the head of the pancreas on computerized tomography (CT) and ultrasonography, malignant tumour of the pancreas or tumour-forming pancreatitis was strongly suspected, and further examination was performed.Magnetic resonance imaging (MRI) results suggested subacute haematoma inside the mass. On angiography, an aneurysm 8 mm in diameter was found in the posterior superior pancreaticoduodenal artery (PSPD). Since an ultrasound-guided percutaneous needle biopsy from the solid part of the mass indicated no malignancy, the lesion was considered an inflammatory pseudotumour in the head of pancreas due to ruptured aneurysm. Bypass surgery was planned, but the tumour shrank significantly with conservative treatment. Obstruction disappeared completely without surgery 4 weeks after the first symptom.

An unusual cause of gastric outlet obstruction: A pancreaticoduodenal artery aneurysm

“…10 Itoh et al reported a case of PDA aneurysm causing pancreatic pseudotumor and duodenal obstruction, which on angiography was an aneurysm of 8 mm in diameter, found in the posterior superior PDA. 11 Androulakakis et al reported a case of a gastric outlet obstruction caused by giant gastroduodenal artery aneurysm. 12 Chiou et al reported a case of pancreaticoduodenal artery aneurysm that began with intestinal angina and weight loss.…”

An Unusual Cause of Gastric Outlet Obstruction: A Pancreaticoduodenal Artery Aneurysm

“…Another case presented with an incarcerated inguinal hernia that subsequently hemorrhaged into the retroperitoneum from a ruptured PDA aneurysm 10. Itoh et al reported a case of PDA aneurysm causing pancreatic pseudotumor and duodenal obstruction, which on angiography was an aneurysm of 8 mm in diameter, found in the posterior superior PDA 11. Androulakakis et al reported a case of a gastric outlet obstruction caused by giant gastroduodenal artery aneurysm 12.…”

Management of Pancreaticoduodenal Artery Aneurysms: Results of Superselective Transcatheter Embolization

“…Some researchers have reported that transcatheter arterial embolization is effective in the treatment of visceral aneurysms, has few complications, and results in low recurrence rates [3][4][6][7][8][9]. Coll et al [3] reported that, since 1980, the mortality rate associated with surgery has been 19%, whereas that associated with transcatheter arterial embolization has been 0%; they reported no significant difference in the risk of recurrent hemorrhage, with rates between 0% and 5%.…”