2023 Volume 43 Issue 5 Pages 909-913
The patient was a 69-year-old man who presented to our emergency room with the complaints of hematemesis and bloody stool. He was hospitalized and blood examination in the emergency ward revealed anemia (Hb 9.3g/dL). Contrast-enhanced computed tomography revealed an aneurysm of the gastro-duodenal artery in the arterial phase measuring 65x45 mm in size. Abdominal angiography revealed extravasation of contrast medium into the duodenum, suggestive of rupture of the aneurysm. Therefore, emergency transcatheter arterial coil embolization was performed. However, the aneurysm re-ruptured on the same day, and repeat arterial embolization was performed, which yielded successful hemostasis. Considering the risk of late rupture of the aneurysm, we performed elective pancreatoduodenectomy on day 8 of hospitalization. Rupture of a gastroduodenal artery aneurysm could be fatal. We conclude that achievement of hemostasis by emergent interventional radiology followed by surgery at an appropriate time could be the best strategy for successfully managing rupture of a gastroduodenal artery aneurysm.
