Gastroduodenal Artery Aneurysm: A Case Report and Concise Review of Literature

Shawky, Mohamed; Tan, Jeffrey; French, Rowan

doi:10.3400/avd.cr.15-00086

Cited by 25 publications

(42 citation statements)

References 11 publications

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“…The pathogenesis of bleeding is probably related to intermittent erosion and the wall destruction of the aneurysm due to contact with Page 3 of 4 the duodenal wall, common bile duct, pseudocyst, or the Wirsung duct, secondary to the pressure necrosis caused by the expanding pseudoaneurysm [10,11]. The image studies of the present case demonstrated intimate contact with the pancreas and the Wirsung duct, simulating pancreatic lesion and even causing, ductal dilatation.…”

Section: Discussionmentioning

confidence: 75%

“…In case of rupturing, the gastrointestinal hemorrhage is the most common clinical manifestation [11,12]. It can cause hematemesis, hemobilia, retroperitoneal hemorrhage, and hemorrhagic shock depending on the location [10,11], once it is broken, mortality can reach up to 70% [2]. An aneurysm of a middle colic artery can display intermittent or slow hemorrhage that lasts for several months [5,6], as the clinical condition is manifested in this case.…”

Section: Discussionmentioning

confidence: 99%

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Pseudoaneurysm Endovascular Treatment of a Middle Colic Arterial Branch in a Patient with an Intermittent Digestive Hemorrhage from an Obscure Source: Case Report

Júnior¹,

Beck²,

Perotoni³

et al. 2017

Vasc Med Surg

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Aneurysms of the middle colic arterial branches are extremely rare, the main manifestation occurs due to the rupture and intraabdominal bleeding making death possible in up to 70% of cases. Herein, we report a case of a male patient, who is 50 years old and displays intermittent, recurrent, and self-limited episodes of a digestive hemorrhage that has been symptomatic during the course of a three-month investigation. After an extensive investigation, the patient was submitted to angiography detecting a pseudoaneurysm in the middle colic branch, being treated by embolization using micro-coils. Intermittent digestive hemorrhages from an obscure source can represent a diagnostic challenge, due to the high degree of clinical suspicion for performing the correct differential diagnosis. Arteriography must not be delayed whenever a pseudoaneurysm with active bleeding is suspected, as this exam is selected for diagnosis and the preferred method for conclusive treatment.

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Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Pseudoaneurysm Endovascular Treatment of a Middle Colic Arterial Branch in a Patient with an Intermittent Digestive Hemorrhage from an Obscure Source: Case Report

Júnior¹,

Beck²,

Perotoni³

et al. 2017

Vasc Med Surg

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“…The interesting part of this case is not only the bleeding gastroduodenal pseudoaneurysm, which it is by itself a rarity, but also the presentation with epigastric pain, hyperamylasaemia and obstructive jaundice. Whereas there are several cases of GDA bleeding aneurysm presenting with obstructive jaundice7 21 22 or gastrointestinal haemorrhage from either direct intraluminal bleeding of the aneurysm in the duodenum2 or indirectly intraductal bleeding inside the common bile duct8 or pancreatic duct, a condition called haemosuccus pancreaticus9 10 or both,23 there is very limited bibliography of GDA cases presenting with hyperamylasaemia 24. The biochemical results can be explained by two mechanisms.…”

Section: Discussionmentioning

confidence: 99%

“…The aetiological factors are not well defined. True aneurysm are mainly caused by hypertension and atherosclerosis,2 whereas pseudoaneurysm by abdominal trauma, such as pancreatic surgery3 and abdominal inflammation, most commonly pancreatitis 4 5. They usually present acutely with haemorrhagic shock due to aneurysm rupture.…”

Section: Introductionmentioning

confidence: 99%

Pseudoaneurysm of the gastroduodenal artery: an unusual cause for hyperamylasaemia

Galanakis¹

2018

BMJ Case Reports

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A 79-year-old man was admitted electively for investigation of weight loss. While he was an inpatient, he developed severe epigastric pain and an initial blood test revealed an acutely raised amylase (>2000) and deranged liver function tests. A contrast CT angiography showed a large haematoma adjacent to the duodenum, spreading in the retroperitoneal space, arising from a 2 cm bleeding pseudoaneurysm in the region of the gastroduodenal artery. Due to his underlying comorbidities, he was deemed unfit for surgical repair and he had coil embolisation with successful haemostasis. The gastroduodenal artery aneurysms are rare and constitute 1.5% of all visceral artery aneurysms. They can be an incidental finding or they can present with haemorrhagic shock, abdominal pain and rarely with obstructive jaundice or hyperamylasaemia. The diagnosis is usually made with an angiography. Variable treatment options are available depending on the patient's fitness and haemodynamic stability.

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“…Such aneurysms have the risk of rupture at the rate of 25%. The mortality rate in ruptured cases is of 70% (1)(2)(3). Gastroduodenal artery aneurysms (GDAA) are a very rare subtype of VAA at the rate of 1.5% (2,4).…”

Section: Introductionmentioning

confidence: 99%

Spontaneous True Gastroduodenal Artery Aneurysm Rupture after an Inguinal Hernia Operation

Kar¹,

Çakır²,

Tanyeli³

et al. 2018

chr

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Gastroduodenal artery aneurysms are a very rare subtype of visceral artery aneurysms. These are divided into two groups as true and pseudoaneurysms. Pseudogastroduodenal artery aneurysms, which develops secondary to pancreatitis, is seen more frequently, whereas the true aneurysms are much less common. Spontaneous rupture may be fatal. Sudden onset of abdominal pain and hypotension are the most important clinical findings. Endovascular interventions are the gold standard for diagnosis. Regardless of their sizes, GDA aneurysms should be treated as soon as possible. In patients diagnosed with gastroduodenal artery aneurysm rupture, endovascular embolization is recommended if the hemodynamics is stable and surgical treatment, if not. Aneurysm ruptures, especially from the GDA divisions, are deeply localized in the pancreas parenchyma and are difficult to detect during the operation. In such cases, the earliest postoperative diagnosis with endovascular intervention and applying embolization are life-saving. The purpose of this study to present a true rupture of gastroduodenal artery aneurysm case causing hemorrhagic shock after the inguinal hernia operation and diagnosed by endovascular intervention after emergency surgical exploration.

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Gastroduodenal Artery Aneurysm: A Case Report and Concise Review of Literature

Cited by 25 publications

References 11 publications

Pseudoaneurysm Endovascular Treatment of a Middle Colic Arterial Branch in a Patient with an Intermittent Digestive Hemorrhage from an Obscure Source: Case Report

Pseudoaneurysm Endovascular Treatment of a Middle Colic Arterial Branch in a Patient with an Intermittent Digestive Hemorrhage from an Obscure Source: Case Report

Pseudoaneurysm of the gastroduodenal artery: an unusual cause for hyperamylasaemia

Spontaneous True Gastroduodenal Artery Aneurysm Rupture after an Inguinal Hernia Operation

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