1887
Volume 2023, Issue 2
  • ISSN: 1999-7086
  • EISSN: 1999-7094

Abstract

Gastroduodenal artery (GDA) aneurysm rupture is a rare cause of upper gastrointestinal bleeding, which is often associated with a high mortality rate if diagnosis or intervention is delayed. Here, we report a case of a 70-year-old man who presented with acute, severe, diffuse abdominal pain and bloody vomiting for two days. The abdominal computed tomography (CT) scan revealed a moderate hemoperitoneum and enhancing focal area in the epigastric region, indicating the ruptured GDA aneurysm. An urgent laparotomy confirmed the diagnosis, and the ruptured GDA was successfully treated by ligation. Fortunately, the patient had an uneventful postoperative recovery and was discharged without complications. In conclusion, early diagnosis and intervention are crucial in reducing the mortality rate associated with GDA aneurysm rupture. Although endovascular repair is the preferred treatment modality, surgical repair may be necessary in cases of hemodynamic instability, unamenable anatomy, unavailable equipment, or lack of subspecialty experience. Thus, physicians must be vigilant in identifying the symptoms of this rare condition and act quickly to provide appropriate treatment.

Loading

Article metrics loading...

/content/journals/10.5339/jemtac.2023.14
2023-06-28
2024-07-24
Loading full text...

Full text loading...

/deliver/fulltext/jemtac/2023/2/jemtac.2023.14.html?itemId=/content/journals/10.5339/jemtac.2023.14&mimeType=html&fmt=ahah

References

  1. Shawky MS, Tan J, French R. Gastroduodenal artery aneurysm: A case report and concise literature review. Ann Vasc Dis. 2015; 8:(4):331–3.
    [Google Scholar]
  2. Huang Y-K, Hsieh H-C, Tsai F-C, Chang S-H, Lu M-S, Ko P-J. Visceral artery aneurysm: Risk factor analysis and therapeutic opinion. Eur J Vasc Endovasc Surg. 2007; 33:(3):293–301.
    [Google Scholar]
  3. Sawicki M, Marlicz W, Czapla N, Łokaj M, Skoczylas MM, Donotek M, et al. Massive upper gastrointestinal bleeding from a splenic artery pseudoaneurysm caused by a penetrating gastric ulcer: Case report and literature review. Pol J Radiol. 2015; 80::384–7.
    [Google Scholar]
  4. Abdelgabar A, d’Archambeau O, Maes J, Van den Brande F, Cools P, Rutsaert RR. Visceral artery pseudoaneurysms: Two case reports and a review of the literature. J Med Case Rep. 2017; 11:(1):126.
    [Google Scholar]
  5. Zarin M, Ali S, Majid A, Jan Z. Gastroduodenal artery aneurysm – Post-traumatic pancreatic pseudocyst drainage - An interesting case. Int J Surg Case Rep. 2018; 42::82–4.
    [Google Scholar]
  6. Ju J, Cheng Z, Zhu Q, Deng M, Zhang H. Pulsation of visible vessel or adherent clot in duodenal ulcer may indicate pseudoaneurysm: Case series. Medicine (Baltimore). 2023; 102:(5):e32819.
    [Google Scholar]
  7. Chang D, Patel P, Persky S, Ng J, Kaell A. Management of gastroduodenal artery pseudoaneurysm rupture with duodenal ulcer complicated by coil migration. ACG Case Rep J. 2020; 7:(4):e00347.
    [Google Scholar]
  8. Santos-Rancaño R, Antona EM, Montero JVM. A challenging case of a large gastroduodenal artery pseudoaneurysm after surgery of a peptic ulcer. Case Rep Surg. 2015; 2015::370937.
    [Google Scholar]
  9. Pulli R, Dorigo W, Troisi N, Pratesi G, Innocenti AA, Pratesi C. Surgical treatment of visceral artery aneurysms: A 25-year experience. J Vasc Surg. 2008; 48:(2):334–42.
    [Google Scholar]
  10. Harris K, Chalhoub M, Koirala A. Gastroduodenal artery aneurysm rupture in hospitalized patients: An overlooked diagnosis. World J Gastrointest Surg. 2010; 2:(9):291–4.
    [Google Scholar]
  11. Kim BSM, Li BT, Engel A, Samra JS, Clarke S, Norton ID, et al. Diagnosis of gastrointestinal bleeding: A practical guide for clinicians. World J Gastrointest Pathophysiol. 2014; 5:(4):467–78.
    [Google Scholar]
  12. Moore E, Matthews MR, Minion DJ, Quick R, Schwarcz TH, Loh FK, et al. Surgical management of peripancreatic arterial aneurysms. J Vasc Surg. 2004; 40:(2):247–53.
    [Google Scholar]
  13. Kyaw M, Tse Y, Ang D, Ang TL, Lau J. Embolization versus surgery for peptic ulcer bleeding after failed endoscopic hemostasis: A meta-analysis. Endosc Int Open. 2014; 2:(1):E6–E14.
    [Google Scholar]
  14. Kuttila K, Havia T, Pekkala E, Ali-Melkkilä T. Surgery of acute peptic ulcer hemorrhage. Ann Chir Gynaecol. 1991; 80:(1):26–9.
    [Google Scholar]
  15. Mille M, Engelhardt T, Stier A. Bleeding duodenal ulcer: Strategies in high-risk ulcers. Visc Med. 2021; 37:(1):52–62.
    [Google Scholar]
/content/journals/10.5339/jemtac.2023.14
Loading
/content/journals/10.5339/jemtac.2023.14
Loading

Data & Media loading...

  • Article Type: Case Report
Keyword(s): aneurysmcase reportgastroduodenal artery and surgical repair
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error