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World J Gastroenterol. Apr 7, 2010; 16(13): 1670-1672
Published online Apr 7, 2010. doi: 10.3748/wjg.v16.i13.1670
Published online Apr 7, 2010. doi: 10.3748/wjg.v16.i13.1670
Therapeutic angiography for giant bleeding gastro-duodenal artery pseudoaneurysm
Ram Elazary, Mahmoud Abu-Gazala, Avraham Schlager, Noam Shussman, Avraham I Rivkind, Department of Surgery, Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel
Allan I Bloom, Department of Radiology, Section of Interventional Radiology, Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel
Author contributions: Elazary R, Abu-Gazala M, Schlager A and Shussman N treated the patient in the emergency room and surgical department and participated in writing the article; Rivkind AI is the chief of surgery who was responsible for the transfer of the patient to our center and for the treatment; Bloom AI performed the angiography and participated in writing the article.
Correspondence to: Ram Elazary, MD, Department of Surgery, Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel. ramelazary@hadassah.org.il
Telephone: +972-2-6778800 Fax: +972-2-6449412
Received: October 28, 2009
Revised: January 14, 2010
Accepted: January 21, 2010
Published online: April 7, 2010
Revised: January 14, 2010
Accepted: January 21, 2010
Published online: April 7, 2010
Abstract
We present the case of an 18-year-old female transferred to our center from an outside hospital due to persistent gastrointestinal bleeding. Two weeks prior to her transfer she underwent duodenal omentopexy for a perforated duodenal peptic ulcer. The patient underwent a computed tomography angiogram which identified the source of bleeding as a giant gastro-duodenal artery (GDA) pseudoaneurysm. The patient was taken to interventional radiology where successful microcoil embolization was performed. We present this rare case of a giant GDA pseudoaneurysm together with imaging and a review of the medical literature regarding prevalence, etiology and treatment options for visceral arterial aneurysms.
Keywords: Gastro-duodenal artery; Gastrointestinal; Bleeding; Angiography; Pseudoaneurysm