Advertisement

Gastroduodenal artery aneurysm presenting as gastric outlet obstruction

      A 30-year-old female with a history of acute biliary pancreatitis two months ago, presented with a four-week history of  recurrent  vomiting,  occurring  one  to  two  hours  after  meals.  The  patientunderwent an endoscopy, showing a 3 cm mass arising from the posterior wall of the duodenal bulb impinging the pyloric opening (Fig. 1A), with overlying normal mucosa. In view of a suspected subepithelial lesion, an endoscopic ultrasound was performed, showing a 3.2 × 2.6 cm aneurysm (Long arrow, Fig. 1B) arising from the gastroduodenal artery (GDA) (Short arrow, Fig. 1B). The patient underwent a conventional angiography showing an aneurysm arising from the proximal part of GDA with a narrow neck (Fig. 1C). Coil embolization was performed, leading to aneurysmal obliteration (Fig. 1D) with symptomatic improvement over the next three days. GDA aneurysm associated with acute pancreatitis is primarily due to periarterial inflammation. The usual presentations are GI bleeding, abdominal pain, or jaundice. However, GDA aneurysms presenting as gastric outlet obstruction are rare, with only one prior reported case [
      • Androulakakis Z.
      • Paspatis G.
      • Hatzidakis A.
      • et al.
      Gastric outlet obstruction caused by a giant gastroduodenal artery aneurysm: a case report.
      ]. Hence, visceral artery aneurysm should be suspected as an etiology apart from pancreatic fluid collections in a patient with acute pancreatitis presenting with gastric outlet obstruction.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Digestive and Liver Disease
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      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