Abstract
We report a rare case of delayed duodenal stenosis, which developed 2 weeks after transarterial embolization (TAE) to treat a ruptured aneurysm of the pancreaticoduodenal artery. A 62-year-old man underwent successful TAE for a ruptured pancreaticoduodenal aneurysm on day 1 of hospitalization. Oral intake was initiated on day 4 of hospitalization ; however, on day 14, he developed delayed duodenal stenosis for which conservative treatment was initiated. Follow-up imaging revealed marked reduction in the retroperitoneal hematoma, although symptoms caused by duodenal stenosis persisted, a laparotomy was performed on day 48 of hospitalization. Intraoperative findings showed extensive fibrotic sclerosis of the retroperitoneum around the duodenum with a small hematoma remnant. Removal of the retroperitoneal hematoma did not resolve the stenosis ; therefore, a gastrojejunostomy was performed. Delayed duodenal stenosis, as was observed in our patient, involving fibrotic sclerosis of the retroperitoneum, is often refractory to conservative treatment. Therefore, surgical treatment including gastrojejunostomy should be considered in such cases.
