scholarly journals A Challenging Case of a Large Gastroduodenal Artery Pseudoaneurysm after Surgery of a Peptic Ulcer

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Rocio Santos-Rancaño ◽  
Esteban Martín Antona ◽  
José Vicente Méndez Montero
Keyword(s):  
Duodenal Ulcer ◽  
Relevant Literature ◽  
Transcatheter Embolization ◽  
Gastroduodenal Artery ◽  
Peptic Ulcers ◽  
Diagnostic Challenge ◽  
Artery Pseudoaneurysm ◽  
Contrast Enhanced ◽  
Postbulbar Duodenal Ulcer ◽  
Enhanced Computed Tomography

We report a 48-year-old man in whom a chronic postbulbar duodenal ulcer destroyed much of the back wall of the duodenum and gastroduodenal artery causing pseudoaneurysm. The lesion was found and evaluated by contrast-enhanced computed tomography (that revealed a large pseudoaneurysm of 83 mm×75 mm in diameter) and by angiography and then treated with transcatheter embolization leading to a complete resolution of the lesion. The case is rare and important for several reasons. First, we demonstrate that pseudoaneurysm of the gastroduodenal artery caused by a duodenal ulcer can occur and present a diagnostic challenge (as far as we know, only three cases have been reported previously in the literature). Second, this case report focuses on the importance of ligation of the gastroduodenal artery when bleeding of peptic ulcers occurs. Additionally, we present an overview of the relevant literature.

scholarly journals Pseudoaneurysm of gastroduodenal artery due to duodenal ulcer causing jaundice and interstitial pancreatitis but not gastrointestinal bleeding

2004 ◽  
Vol 132 (3-4) ◽  
pp. 108-111 ◽  
Author(s):  
Miodrag Jovanovic ◽  
Radoje Colovic ◽  
Nikica Grubor ◽  
Mirjana Perisic ◽  
Vladimir Radak
Keyword(s):  
Duodenal Ulcer ◽  
Gastrointestinal Bleeding ◽  
Heavy Drinking ◽  
Gastroduodenal Artery ◽  
Operative Trauma ◽  
Billroth Ii Gastrectomy ◽  
Successful Recovery ◽  
Pseudo Aneurysm ◽  
Alcohol Consumer ◽  
Postbulbar Duodenal Ulcer

Aneurysms and pseudoaneurysms of the gastroduodenal artery are rare with less then 50 cases reported. Most frequently they are one of the consequences of pancreatitis much rarer duodenal ulcer or operative trauma during gastrectomy for duodenal ulcer or choledochotomy. We report on a 47 year-old man, chronic heavy alcohol consumer in whom a chronic postbulbar duodenal ulcer destroyed much of the back wall of the duodenum, eroded gastroduodenal artery causing pseudo-aneurysm but without noticeable gastrointestinal bleeding. The patient had jaundice of obstructive type and elevated amilase. After Billroth II gastrectomy, suture of the gastroduodenal artery, cholecystectomy and T tube drainage of the common bile duct the patient developed intestinal obstruction caused by two interintestinal abscesses so that he had to be reoperated. After that he had a successful recovery, his general health greatly improved, he gained 15 kg in weight but two years after surgery he again started with heavy drinking and soon died due to serious brain damage. The case is rare and unusual at least for few reasons: First, the pseudoaneurysm was caused by duodenal ulcer. Second, a serious gastrointestinal bleeding did not take place. Third, the pseudoaneurysm was diagnosed by Doppler ultrasonography while angiography failed to opacity it due to thrombosis of the artery.

scholarly journals Management of Gastroduodenal Artery Pseudoaneurysm Rupture With Duodenal Ulcer Complicated by Coil Migration

2020 ◽  
Vol 7 (4) ◽  
pp. e00347
Author(s):  
Dennis Chang ◽  
Purvi Patel ◽  
Seth Persky ◽  
Joseph Ng ◽  
Alan Kaell
Keyword(s):  
Duodenal Ulcer ◽  
Gastroduodenal Artery ◽  
Artery Pseudoaneurysm ◽  
Coil Migration

Transarterial Embolization With Complementary Surgical Ligation of Gastroduodenal Artery for Ruptured Pancreaticoduodenal Artery Aneurysm

2019 ◽  
Vol 53 (7) ◽  
pp. 593-598 ◽  
Author(s):  
Toru Imagami ◽  
Satoru Takayama ◽  
Taku Hattori ◽  
Ryohei Matsui ◽  
Hisanori Kani ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
Transarterial Embolization ◽  
Artery Aneurysm ◽  
Celiac Artery ◽  
Gastroduodenal Artery ◽  
Contrast Enhanced ◽  
Pancreaticoduodenal Artery Aneurysm ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

The association between pancreaticoduodenal artery aneurysm (PDAA) and local hemodynamic changes in pancreaticoduodenal arcades is well established. However, there are few case reports of PDAA associated with acute aortic dissection. In this article, we outline and discuss the case of a 61-year-old man diagnosed with a type A acute aortic dissection who underwent emergency surgery and developed sudden-onset severe abdominal pain and shock 10 days later. Contrast-enhanced computed tomography showed a ruptured PDAA with feeding vessels from the gastroduodenal and superior mesenteric arteries, with evidence that the celiac artery was diverged from a false lumen. Transarterial embolization via the superior mesenteric artery alone was not expected to achieve hemostasis, so we performed a hybrid procedure involving transarterial embolization cannulated from superior mesenteric artery with complementary surgical ligation of the gastroduodenal artery. The postoperative course was uneventful, and follow-up contrast-enhanced computed tomography showed no persistence of the aneurysm 8 days after the second operation. This case proposed that visceral arterial malperfusion due to acute aortic dissection can cause PDAA in the early postoperative period. Although previous reports suggest that endovascular treatment is preferable, it may not always be feasible. Since ruptured PDAAs are often not detected during surgery, surgical treatment can be overly invasive. Whereas, transarterial embolization with complementary clamping or ligation of the gastroduodenal artery for ruptured PDAA is less invasive and can control hemorrhage, especially when cannulation to the celiac artery is impossible. Notably, the technique did not cause organ ischemia, presumably because the small collateral vessels of the pancreaticoduodenal arcades permitted sufficient blood flow. If endovascular treatment is unable to achieve rapid hemostasis, this technique may be a useful option for ruptured PDAA.

Erodes and bleeds, fistulises and obstructs: Bouveret’s syndrome

2020 ◽  
Vol 50 (4) ◽  
pp. 383-385
Author(s):  
Rinkal B Kakadiya ◽  
Uttam Thakur ◽  
Lileshwar Kaman ◽  
Harshal S Mandavdhare
Keyword(s):  
Gallstone Ileus ◽  
Outlet Obstruction ◽  
Bouveret’S Syndrome ◽  
Artery Pseudoaneurysm ◽  
Contrast Enhanced ◽  
Complications Of Cholelithiasis ◽  
Enhanced Computed Tomography ◽  
Bouveret's Syndrome ◽  
Contrast Enhanced Computed Tomography ◽  
Upper Gastrointestinal

One of the rare complications of cholelithiasis is gallstone ileus which occurs in <5% of patients. Among them, <3% develop Bouveret’s syndrome: gastric outlet obstruction by a large gallstone in the pylorus or duodenum. One large review of 128 patients showed it to present at a mean age of 74.1 ± 11.1 years with a mean gallstone size of 4.6 ± 1.5 cm, with nausea or vomiting in 86%, abdominal pain in 71% and haematemesis in 15%. The diagnosis is usually clear on oesophagogastroduodenoscopy or abdominal contrast-enhanced computed tomography. We present a case with massive upper gastrointestinal bleeding, due to erosion of a cystic artery pseudoaneurysm.

Coil Embolization of a Left Pulmonary Artery Pseudoaneurysm after Penetrating Injury

2003 ◽  
Vol 10 (3) ◽  
pp. 681-683 ◽  
Author(s):  
Ingeborg de Jonge ◽  
Anco Vahl ◽  
Victor van der Hulst
Keyword(s):  
Pulmonary Artery ◽  
Coil Embolization ◽  
Left Lung ◽  
Left Pulmonary Artery ◽  
Artery Pseudoaneurysm ◽  
Contrast Enhanced ◽  
Pulmonary Arteriography ◽  
Feeding Vessels ◽  
Enhanced Computed Tomography ◽  
Pulmonary Artery Pseudoaneurysm

Purpose: To report successful coil embolization of a rare traumatic pulmonary artery pseudoaneurysm. Case Report: A 57-year-old man developed a pulmonary artery pseudoaneurysm 14 days after he had been stabbed with a knife in the left lung. The pseudoaneurysm was diagnosed with contrast-enhanced computed tomography and confirmed by pulmonary arteriography. Coils were deployed in the feeding vessels to occlude the defect. Conclusions: Pulmonary artery pseudoaneurysm after penetrating chest injury can be treated by percutaneous catheter embolization, which is less invasive than surgery.

scholarly journals Hybrid surgery for a severe infectious innominate artery pseudoaneurysm compressing the main trachea

2020 ◽  
Vol 48 (10) ◽  
pp. 030006052096584
Author(s):  
Li-Shan Lian ◽  
Zhe Zhang ◽  
Hai Feng ◽  
Xue-Ming Chen
Keyword(s):  
Saphenous Vein Graft ◽  
Innominate Artery ◽  
Covered Stent ◽  
Massive Hemorrhage ◽  
Hybrid Surgery ◽  
Artery Pseudoaneurysm ◽  
Contrast Enhanced ◽  
The Right ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

Here, we report a case of an infectious pseudoaneurysm at the root of the innominate artery, compressing the trachea, that resulted in massive hemorrhage due to rupture of the innominate artery. The patient, a 31-year-old man, had complained of persistent fever for 40 days and severe dyspnea for 1 week. Contrast-enhanced computed tomography imaging of neck and thorax showed a pseudoaneurysm originating from the root of the innominate artery that was severely compressing the main trachea. A hybrid surgery strategy was applied. We first implanted a covered stent in the root of the innominate artery. Then, we performed a left-to-right carotid−carotid bypass with a great saphenous vein graft. Finally, we performed a median thoracotomy in which both the pseudoaneurysm and the previously implanted covered stent were successfully extracted. The patient lost strength in the right upper limb muscle on postoperative day 2 but recovered to baseline strength after 3 months. A hybrid surgical technique may represent a practical solution for such conditions.

Sign in / Sign up

Export Citation Format

Share Document