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Unusual case of upper gastrointestinal haemorrhage secondary to a ruptured gastroduodenal artery pseudoaneurysm: case presentation and literature review
  1. Gasim Ahmed,
  2. Mehsim Abid,
  3. Sharath Hosmane and
  4. Smitha Mathew
  1. Radiology Department, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, Lancashire, UK
  1. Correspondence to Dr Gasim Ahmed; gasimsalaheldin{at}yahoo.com

Abstract

Pseudoaneurysm rupture of the gastroduodenal artery (GDA) is life-threatening and can present as an acute upper gastrointestinal haemorrhage. Here, we present a case of upper gastrointestinal haemorrhage arising from a ruptured GDA pseudoaneurysm. A 56-year-old woman presented acutely with haematemesis. She reported ongoing upper epigastric pain for a few weeks. Laboratory evaluation revealed severe microcytic hypochromic anaemia (haemoglobin, 69 g/L; normal, 120–140 g/L) and a mildly raised serum amylase level. Upper gastrointestinal endoscopy revealed dark blood collection between the rugae of the distal stomach. An abdominal CT scan detected a homogeneously enhancing rounded lesion arising from the GDA adjacent to the second part of the duodenum. The median arcuate ligament was causing stenosis of the coeliac axis origin. The diagnosis of haematemesis secondary to a ruptured GDA pseudoaneurysm was confirmed by mesenteric angiography, and aneurysmal embolisation was done. The haemoglobin level stabilised after aneurysmal embolisation.

  • GI bleeding
  • medical education
  • radiology
  • interventional radiology
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Footnotes

  • Twitter @mehsimabid

  • Contributors GA is the main author who contributed to writing the whole article. MA contributed to writing the clinical presentation section and carried out patient consenting. SH provided interventional radiology input and image selection. SM is the supervising consultant.

  • 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 for publication Obtained.

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

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