Article ID: 2024-0020
A 78-year-old man who had been treated for perihilar cholangiocarcinoma presented with hematemesis 1.5 years later. Computed tomography revealed a pseudoaneurysm of the proper hepatic artery protruding into the lumen of the duodenum. Esophagogastroduodenoscopy revealed a duodenal ulcer with massive hemorrhage at the duodenal bulb. Endoscopic hemostasis therapy was not possible due to the exposure of the proper hepatic artery pseudoaneurysm to the duodenal lumen. Endovascular stent-graft placement was chosen; the proper hepatic artery pseudoaneurysm disappeared and hematemesis was no longer observed. However, 2.5 years later, he presented with hematemesis, and esophagogastroduodenoscopy showed migration of the stent-graft into the duodenum due to duodenal ulcer recurrence.
