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

Abstract

We present a rare case of gastric outlet obstruction due to compression of the duodenum by a pancreaticoduodenal artery (PDA) aneurysm 2.5 cm in diameter, in a 43-year-old man from Saudi Arabia who presented with persistent vomiting and epigastric pain. The initial investigations and blood works were negative, and esophagogastroduodenoscopy (EGD) was unremarkable. A CT abdomen demonstrated a mass around the duodenum and dilatation of the stomach, and CT angiography showed the PDA aneurysm. The patient was stabilized and then referred to a tertiary center for embolization. Our case demonstrates a diagnostic challenge that physicians may encounter in patients who present with vomiting and epigastric pain.

Rupture of an Idiopathic Aneurysm of the Inferior Pancreaticoduodenal Artery Leading to an Intra-Abdominal Bleeding

“…There are diversified clinical pictures of patients presenting with PDA aneurysm, with the majority of previously reported cases presenting signs of epigastric outlet obstruction including: epigastric pain, nausea and vomiting [6,7], while other cases presented with signs of gastrointestinal bleeding and anemia [8]. The patient in this study presented with an extremely unusual clinical picture of PDA aneurysm, with hemorrhagic shock due to intra-abdominal bleeding.…”

Pseudoaneurysm of the Inferior Pancreaticoduodenal Artery Due to Cholecystitis

“…Cases of pancreaticoduodenal artery aneurysms have caused nausea and vomiting, and this was normally due to gastric outlet obstruction [6,7]. A case of a pancreaticoduodenal aneurysm arising from a pancreatic pseudotumour caused a duodenal obstruction, giving symptoms of nausea and vomiting [8].…”

An Unusual Case of Gastric Outlet Obstruction After Embolization of Gastroduodenal Artery Pseudoaneurysm

“…Other causes of gastric outlet obstruction are relatively uncommon and include gastric tuberculosis, annular pancreas, corrosive ingestion, gastric polyps, Crohn’s disease, Bouverete syndrome and gastric volvulus. Gastric outlet obstruction from visceral artery aneurysms is rare and a subject of a few case reports [ 3 , 4 ]. To the best of our knowledge, no cases are found in the literature of gastric outlet obstruction after embolization of visceral artery aneurysms and pseudoaneurysms.…”