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Case Reports
. 2018 Apr 11:2018:bcr2017223882.
doi: 10.1136/bcr-2017-223882.

Pseudoaneurysm of the gastroduodenal artery: an unusual cause for hyperamylasaemia

Vasileios Galanakis  1
Affiliations
Case Reports

Pseudoaneurysm of the gastroduodenal artery: an unusual cause for hyperamylasaemia

Vasileios Galanakis. BMJ Case Rep. .

Abstract

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.

Keywords: gi bleeding; pancreas and biliary tract.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Axial plane of non-contrast abdominal CT scan. Thin arrow: common bile duct. Dash arrow: gastroduodenal artery pseudoaneurysm. Thick arrow: retroperitoneal haematoma. Note the close proximity of the common bile duct with the gastroduodenal artery pseudoaneurysm.
Figure 2
Figure 2
Coronal plane of non-contrast abdominal CT scan. Thin arrow: common bile duct. Dash arrow: gastroduodenal artery pseudoaneurysm. Thick arrow: retroperitoneal haematoma. Note the close proximity of the common bile duct with the gastroduodenal artery pseudoaneurysm.
Figure 3
Figure 3
Pre-coil embolisation. Dash arrow: gastroduodenal artery with contrast. Thin arrow: bleeding point from the gastroduodenal artery pseudoaneurysm. Contrast is seen outside the vessel.
Figure 4
Figure 4
Post-coil embolisation. Dash arrow: coil deployed in the gastroduodenal artery. Thin arrow: the bleeding has stopped as no contrast is seen outside the vessel.
See this image and copyright information in PMC

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