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Published in: Digestive Diseases and Sciences 11/2019

01-11-2019 | Arteriography | DDS–SIRC COOPERATIVE CONFERENCES

False in Name Only—Gastroduodenal Artery Pseudoaneurysm in a Recurrently Bleeding Patient: Case Report and Literature Review

Authors: M. Binetti, A. Lauro, R. Golfieri, S. Vaccari, V. D’Andrea, I. R. Marino, M. Cervellera, M. Renzulli, V. Tonini

Published in: Digestive Diseases and Sciences | Issue 11/2019

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Abstract

Although the diagnosis of visceral pseudoaneurysm is unusual, it requires emergent attention due to the risk of rupture. We describe a 70-year-old man with a gastroduodenal artery pseudoaneurysm that manifested as recurrent hemorrhage. We highlight the possible etiologies, clinical presentations, diagnostic tools, and treatment options for this condition. In this instance, the patient was successfully treated by selective angioembolization. A visceral pseudoaneurysm should be considered in patients with abdominal pain and GI hemorrhage. At present, angioembolization is a first-line therapy.
Literature
1.
go back to reference Awada Z, Al Moussawi H, Alsheikh M, et al. Gastroduodenal artery pseudoaneurysm rupture post-Billroth II surgery: case report. Cureus. 2019;11:e3833.PubMedPubMedCentral Awada Z, Al Moussawi H, Alsheikh M, et al. Gastroduodenal artery pseudoaneurysm rupture post-Billroth II surgery: case report. Cureus. 2019;11:e3833.PubMedPubMedCentral
2.
go back to reference Matsuno Y, Mori Y, Umeda Y, et al. Surgical repair of true gastroduodenal artery aneurysm: a case report. Vasc Endovasc Surg. 2008;42:497–499.CrossRef Matsuno Y, Mori Y, Umeda Y, et al. Surgical repair of true gastroduodenal artery aneurysm: a case report. Vasc Endovasc Surg. 2008;42:497–499.CrossRef
3.
go back to reference Abdelgabar A, d’Archambeau O, Maes J, et al. Visceral artery pseudoaneurysms: two case reports and a review of the literature. J Med Case Rep. 2017;11:126.CrossRef Abdelgabar A, d’Archambeau O, Maes J, et al. Visceral artery pseudoaneurysms: two case reports and a review of the literature. J Med Case Rep. 2017;11:126.CrossRef
4.
go back to reference She WH, Tsang S, Poon R, et al. Gastrointestinal bleeding of obscured origin due to cystic artery pseudoaneurysm. Asian J Surg. 2017;40:320–323.CrossRef She WH, Tsang S, Poon R, et al. Gastrointestinal bleeding of obscured origin due to cystic artery pseudoaneurysm. Asian J Surg. 2017;40:320–323.CrossRef
5.
go back to reference Fujio A, Usuda M, Ozawa Y, et al. A case of gastrointestinal bleeding due to right hepatic artery pseudoaneurysm following total remnant pancreatectomy: a case report. Int J Surg Case Rep. 2017;41:434–437.CrossRef Fujio A, Usuda M, Ozawa Y, et al. A case of gastrointestinal bleeding due to right hepatic artery pseudoaneurysm following total remnant pancreatectomy: a case report. Int J Surg Case Rep. 2017;41:434–437.CrossRef
6.
go back to reference Sharma M, Somani P, Sunkara T, et al. Endoscopic ultrasound-guided coil embolization and thrombin injection of a bleeding gastroduodenal artery pseudoaneurysm. Endoscopy. 2019;51:E36–E37.CrossRef Sharma M, Somani P, Sunkara T, et al. Endoscopic ultrasound-guided coil embolization and thrombin injection of a bleeding gastroduodenal artery pseudoaneurysm. Endoscopy. 2019;51:E36–E37.CrossRef
7.
go back to reference Iyori K, Horigome M, Yumoto S, et al. Aneurysm of the gastroduodenal artery associated with absence of the celiac axis: report of a case. Surg Today. 2004;34:360–362.CrossRef Iyori K, Horigome M, Yumoto S, et al. Aneurysm of the gastroduodenal artery associated with absence of the celiac axis: report of a case. Surg Today. 2004;34:360–362.CrossRef
8.
go back to reference Bergert H, Hinterseher I, Kersting S, et al. Management and outcome of hemorrhage due to arterial pseudoaneurysms in pancreatitis. Surgery. 2005;137:323–328.CrossRef Bergert H, Hinterseher I, Kersting S, et al. Management and outcome of hemorrhage due to arterial pseudoaneurysms in pancreatitis. Surgery. 2005;137:323–328.CrossRef
9.
go back to reference Koyazounda A, Jaillot P, Persico J, et al. Aneurysm of the gastroduodenal artery ruptured into the peritoneum. Treatment by embolization. Presse Medicale Paris Fr 1983. 1994;23:661–664. Koyazounda A, Jaillot P, Persico J, et al. Aneurysm of the gastroduodenal artery ruptured into the peritoneum. Treatment by embolization. Presse Medicale Paris Fr 1983. 1994;23:661–664.
10.
go back to reference Chong WW, Tan SG, Htoo MM, et al. Endovascular treatment of gastroduodenal artery aneurysm. Asian Cardiovasc Thorac Ann. 2008;16:68–72.CrossRef Chong WW, Tan SG, Htoo MM, et al. Endovascular treatment of gastroduodenal artery aneurysm. Asian Cardiovasc Thorac Ann. 2008;16:68–72.CrossRef
11.
go back to reference Shanley CJ, Shah NL, Messina LM, et al. Uncommon splanchnic artery aneurysms: pancreaticoduodenal, gastroduodenal, superior mesenteric, inferior mesenteric, and colic. Ann Vasc Surg. 1996;10:506–515.CrossRef Shanley CJ, Shah NL, Messina LM, et al. Uncommon splanchnic artery aneurysms: pancreaticoduodenal, gastroduodenal, superior mesenteric, inferior mesenteric, and colic. Ann Vasc Surg. 1996;10:506–515.CrossRef
12.
go back to reference Sethi H, Peddu P, Prachalias A, et al. Selective embolization for bleeding visceral artery pseudoaneurysms in patients with pancreatitis. Hepatobiliary Pancreat Dis Int. 2010;9:634–638.PubMed Sethi H, Peddu P, Prachalias A, et al. Selective embolization for bleeding visceral artery pseudoaneurysms in patients with pancreatitis. Hepatobiliary Pancreat Dis Int. 2010;9:634–638.PubMed
13.
go back to reference Gião Antunes A, Peixe B, Guerreiro H, et al. Spontaneous thrombosis of a gastroduodenal artery pseudoaneurysm manifesting as a subepithelial lesion. Rev Gastroenterol México Engl Ed. 2018;83:354–356. Gião Antunes A, Peixe B, Guerreiro H, et al. Spontaneous thrombosis of a gastroduodenal artery pseudoaneurysm manifesting as a subepithelial lesion. Rev Gastroenterol México Engl Ed. 2018;83:354–356.
14.
go back to reference Carrafiello G, Laganà D, Recaldini C, et al. Combined percutaneous thrombin injection and endovascular treatment of gastroduodenal artery pseudoaneurysm (PAGD): case report. Emerg Radiol. 2007;14:51–54.CrossRef Carrafiello G, Laganà D, Recaldini C, et al. Combined percutaneous thrombin injection and endovascular treatment of gastroduodenal artery pseudoaneurysm (PAGD): case report. Emerg Radiol. 2007;14:51–54.CrossRef
15.
go back to reference Habib N, Hassan S, Abdou R, et al. Gastroduodenal artery aneurysm, diagnosis, clinical presentation and management: a concise review. Ann Surg Innov Res. 2013;7:4.CrossRef Habib N, Hassan S, Abdou R, et al. Gastroduodenal artery aneurysm, diagnosis, clinical presentation and management: a concise review. Ann Surg Innov Res. 2013;7:4.CrossRef
16.
go back to reference Burke JW, Erickson SJ, Kellum CD, et al. Pseudoaneurysms complicating pancreatitis: detection by CT. Radiology. 1986;161:447–450.CrossRef Burke JW, Erickson SJ, Kellum CD, et al. Pseudoaneurysms complicating pancreatitis: detection by CT. Radiology. 1986;161:447–450.CrossRef
17.
go back to reference Kasirajan K, Greenberg RK, Clair D, et al. Endovascular management of visceral artery aneurysm. J Endovasc Ther. 2001;8:150–155.CrossRef Kasirajan K, Greenberg RK, Clair D, et al. Endovascular management of visceral artery aneurysm. J Endovasc Ther. 2001;8:150–155.CrossRef
18.
go back to reference Gupta V, Irrinki S, Sakaray YR, et al. Treatment strategies for bleeding from gastroduodenal artery pseudoaneurysms complicating the course of chronic pancreatitis-a case series of 10 patients. Indian J Gastroenterol Off J Indian Soc Gastroenterol. 2018;37:457–463.CrossRef Gupta V, Irrinki S, Sakaray YR, et al. Treatment strategies for bleeding from gastroduodenal artery pseudoaneurysms complicating the course of chronic pancreatitis-a case series of 10 patients. Indian J Gastroenterol Off J Indian Soc Gastroenterol. 2018;37:457–463.CrossRef
19.
go back to reference Hsu J-T, Yeh C-N, Hung C-F, et al. Management and outcome of bleeding pseudoaneurysm associated with chronic pancreatitis. BMC Gastroenterol. 2006;6:3.CrossRef Hsu J-T, Yeh C-N, Hung C-F, et al. Management and outcome of bleeding pseudoaneurysm associated with chronic pancreatitis. BMC Gastroenterol. 2006;6:3.CrossRef
20.
go back to reference Galanakis V. Pseudoaneurysm of the gastroduodenal artery: an unusual cause for hyperamylasaemia. BMJ Case Rep. 2018;2018. Galanakis V. Pseudoaneurysm of the gastroduodenal artery: an unusual cause for hyperamylasaemia. BMJ Case Rep. 2018;2018.
21.
go back to reference Santos-Rancaño R, Antona EM, Montero JVM, et al. A challenging case of a large gastroduodenal artery pseudoaneurysm after surgery of a peptic ulcer. Case Rep Surg. 2015;2015:370937.PubMedPubMedCentral Santos-Rancaño R, Antona EM, Montero JVM, et al. A challenging case of a large gastroduodenal artery pseudoaneurysm after surgery of a peptic ulcer. Case Rep Surg. 2015;2015:370937.PubMedPubMedCentral
22.
go back to reference Elazary R, Abu-Gazala M, Schlager A, et al. Therapeutic angiography for giant bleeding gastro-duodenal artery pseudoaneurysm. World J Gastroenterol. 2010;16:1670–1672.CrossRef Elazary R, Abu-Gazala M, Schlager A, et al. Therapeutic angiography for giant bleeding gastro-duodenal artery pseudoaneurysm. World J Gastroenterol. 2010;16:1670–1672.CrossRef
23.
go back to reference Geoghegan T, Tuite D, McAuley G, et al. Percutaneous thrombin injection for the treatment of a post-pancreatitis pseudoaneurysm of the gastroduodenal artery. Eur Radiol. 2004;14:2144–2145.CrossRef Geoghegan T, Tuite D, McAuley G, et al. Percutaneous thrombin injection for the treatment of a post-pancreatitis pseudoaneurysm of the gastroduodenal artery. Eur Radiol. 2004;14:2144–2145.CrossRef
24.
go back to reference Klauß M, Heye T, Stampfl U, et al. Successful arterial embolization of a giant pseudoaneurysm of the gastroduodenal artery secondary to chronic pancreatitis with literature review. J Radiol Case Rep. 2012;6:9–16.PubMedPubMedCentral Klauß M, Heye T, Stampfl U, et al. Successful arterial embolization of a giant pseudoaneurysm of the gastroduodenal artery secondary to chronic pancreatitis with literature review. J Radiol Case Rep. 2012;6:9–16.PubMedPubMedCentral
25.
go back to reference Volpi MA, Voliovici E, Pinato F, et al. Pseudoaneurysm of the gastroduodenal artery secondary to chronic pancreatitis. Ann Vasc Surg. 2010;24:1136.e7–1136.e11.CrossRef Volpi MA, Voliovici E, Pinato F, et al. Pseudoaneurysm of the gastroduodenal artery secondary to chronic pancreatitis. Ann Vasc Surg. 2010;24:1136.e7–1136.e11.CrossRef
26.
go back to reference Dirks K, Schuler A, Lutz H, et al. An unusual cause of gastrointestinal hemorrhage: pseudoaneurysm of the gastroduodenal artery in chronic pancreatitis. Z Gastroenterol. 1999;37:489–493.PubMed Dirks K, Schuler A, Lutz H, et al. An unusual cause of gastrointestinal hemorrhage: pseudoaneurysm of the gastroduodenal artery in chronic pancreatitis. Z Gastroenterol. 1999;37:489–493.PubMed
27.
go back to reference Germanos S, Soonawalla Z, Stratopoulos C, et al. Pseudoaneurysm of the gastroduodenal artery in chronic pancreatitis. J Am Coll Surg. 2009;208:316.CrossRef Germanos S, Soonawalla Z, Stratopoulos C, et al. Pseudoaneurysm of the gastroduodenal artery in chronic pancreatitis. J Am Coll Surg. 2009;208:316.CrossRef
28.
go back to reference Jovanović M, Colović R, Grubov N, et al. Pseudoaneurysm of gastroduodenal artery due to duodenal ulcer causing jaundice and interstitial pancreatitis but not bleeding. Srp Arh Celok Lek. 2004;132:108–111.CrossRef Jovanović M, Colović R, Grubov N, et al. Pseudoaneurysm of gastroduodenal artery due to duodenal ulcer causing jaundice and interstitial pancreatitis but not bleeding. Srp Arh Celok Lek. 2004;132:108–111.CrossRef
29.
go back to reference Vizsy L, Beznicza H, Petoházi A, et al. Successfully operated ruptured gastroduodenal artery pseudoaneurysm. Orv Hetil. 2006;147:1279–1281.PubMed Vizsy L, Beznicza H, Petoházi A, et al. Successfully operated ruptured gastroduodenal artery pseudoaneurysm. Orv Hetil. 2006;147:1279–1281.PubMed
30.
go back to reference Singh O, Gupta SS, Raikwar RS, et al. A rare case of ‘Spontaneous rupture of partially thrombosed pseudoaneurysm of gastroduodenal artery associated with chronic pancreatitis’. Indian J Surg. 2009;71:282–283.CrossRef Singh O, Gupta SS, Raikwar RS, et al. A rare case of ‘Spontaneous rupture of partially thrombosed pseudoaneurysm of gastroduodenal artery associated with chronic pancreatitis’. Indian J Surg. 2009;71:282–283.CrossRef
31.
go back to reference Yen Y-T, Lai H-W, Lin C-H, et al. Endovascular salvage for contained rupture of gastroduodenal artery aneurysm presented with obstructive jaundice. Ann Vasc Surg. 2015;29:1017.e1–1017.e5.CrossRef Yen Y-T, Lai H-W, Lin C-H, et al. Endovascular salvage for contained rupture of gastroduodenal artery aneurysm presented with obstructive jaundice. Ann Vasc Surg. 2015;29:1017.e1–1017.e5.CrossRef
32.
go back to reference Akbari K, Wood C, Ahmad N, et al. Gastroduodenal artery aneurysm. BMJ Case Rep. 2014;2014. Akbari K, Wood C, Ahmad N, et al. Gastroduodenal artery aneurysm. BMJ Case Rep. 2014;2014.
33.
go back to reference Androulakakis Z, Paspatis G, Hatzidakis A, et al. Gastric outlet obstruction caused by a giant gastroduodenal artery aneurysm: a case report. Eur J Gastroenterol Hepatol. 2001;13:59–61.CrossRef Androulakakis Z, Paspatis G, Hatzidakis A, et al. Gastric outlet obstruction caused by a giant gastroduodenal artery aneurysm: a case report. Eur J Gastroenterol Hepatol. 2001;13:59–61.CrossRef
34.
go back to reference Kueper MA, Ludescher B, Koenigsrainer I, et al. Successful coil embolization of a ruptured gastroduodenal artery aneurysm. Vasc Endovasc Surg. 2007;41:568–571.CrossRef Kueper MA, Ludescher B, Koenigsrainer I, et al. Successful coil embolization of a ruptured gastroduodenal artery aneurysm. Vasc Endovasc Surg. 2007;41:568–571.CrossRef
35.
go back to reference Lykoudis PM, Stafyla VK, Koutoulidis V, et al. Stenting of a gastroduodenal artery aneurysm: report of a case. Surg Today. 2012;42:72–74.CrossRef Lykoudis PM, Stafyla VK, Koutoulidis V, et al. Stenting of a gastroduodenal artery aneurysm: report of a case. Surg Today. 2012;42:72–74.CrossRef
36.
go back to reference Marjanovic IR, Jevtic M, Misovic S, et al. Endovascular reconstruction of giant gastroduodenal artery aneurysm with stent graft: case report. Vasc Endovasc Surg. 2010;44:392–394.CrossRef Marjanovic IR, Jevtic M, Misovic S, et al. Endovascular reconstruction of giant gastroduodenal artery aneurysm with stent graft: case report. Vasc Endovasc Surg. 2010;44:392–394.CrossRef
37.
go back to reference Piffaretti G, Tozzi M, Carrafiello G, et al. A case of gastroduodenal artery aneurysm in a HIV-positive patient treated by combined percutaneous thrombin injection and endovascular coil embolization. J Cardiovasc Surg. 2008;49:659–661. Piffaretti G, Tozzi M, Carrafiello G, et al. A case of gastroduodenal artery aneurysm in a HIV-positive patient treated by combined percutaneous thrombin injection and endovascular coil embolization. J Cardiovasc Surg. 2008;49:659–661.
38.
go back to reference Savage J, Hsee L. Spontaneous gastroduodenal artery aneurysm rupture in acute surgery. N Z Med J. 2012;125:155–157.PubMed Savage J, Hsee L. Spontaneous gastroduodenal artery aneurysm rupture in acute surgery. N Z Med J. 2012;125:155–157.PubMed
39.
go back to reference Sun MS, Wang HP, Lin JT. Gastroduodenal artery aneurysm mimicking a bleeding submucosal tumor. Gastrointest Endosc. 2001;54:621.CrossRef Sun MS, Wang HP, Lin JT. Gastroduodenal artery aneurysm mimicking a bleeding submucosal tumor. Gastrointest Endosc. 2001;54:621.CrossRef
Metadata
Title
False in Name Only—Gastroduodenal Artery Pseudoaneurysm in a Recurrently Bleeding Patient: Case Report and Literature Review
Authors
M. Binetti
A. Lauro
R. Golfieri
S. Vaccari
V. D’Andrea
I. R. Marino
M. Cervellera
M. Renzulli
V. Tonini
Publication date
01-11-2019
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 11/2019
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-019-05853-7

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