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BMJ Case Reports 2018; doi:10.1136/bcr-2017-223882
  • Unusual presentation of more common disease/injury
  • CASE REPORT

Pseudoaneurysm of the gastroduodenal artery: an unusual cause for hyperamylasaemia

  1. Vasileios Galanakis
  1. Department of Gastroenterology, Ipswich Hospital NHS Trust, Ipswich, UK
  1. Correspondence to Dr Vasileios Galanakis, vasilisgalan{at}gmail.com
  • Accepted 24 March 2018
  • Published 11 April 2018

Summary

A 79-year-old man was admitted electively for investigation of weight loss. While he was an inpatient, he developed severe epigastric pain and an initial blood test revealed an acutely raised amylase (>2000) and deranged liver function tests. A contrast CT angiography showed a large haematoma adjacent to the duodenum, spreading in the retroperitoneal space, arising from a 2 cm bleeding pseudoaneurysm in the region of the gastroduodenal artery. Due to his underlying comorbidities, he was deemed unfit for surgical repair and he had coil embolisation with successful haemostasis. The gastroduodenal artery aneurysms are rare and constitute 1.5% of all visceral artery aneurysms. They can be an incidental finding or they can present with haemorrhagic shock, abdominal pain and rarely with obstructive jaundice or hyperamylasaemia. The diagnosis is usually made with an angiography. Variable treatment options are available depending on the patient’s fitness and haemodynamic stability.

Footnotes

  • Contributors VG is the sole author of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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