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Case Reports
. 2025 Jan;9(1):95-97.
doi: 10.5811/cpcem.35400.

Case Report: Testicular Pseudoaneurysm Rupture

Caroline Baber  1 , Eshaan Daas  1 , Michelle Mouri  1
Affiliations
Case Reports

Case Report: Testicular Pseudoaneurysm Rupture

Caroline Baber et al. Clin Pract Cases Emerg Med. 2025 Jan.

Abstract

Introduction: Gastroduodenal artery embolization is an increasingly common treatment method in patients with upper gastrointestinal (GI) bleeding who fail endoscopy or as a prophylactic procedure to help prevent further episodes. However, this new technique includes new risks including GI tract ischemia and risks associated with endovascular access such as hematoma formation, pseudoaneurysm development, and arterial dissection.

Case report: We discuss a case of 51-year-old male with recurrent upper GI bleeding who presented to the emergency department for scrotal swelling following the prophylactic embolization of his gastroduodenal artery. He was subsequently found to have a ruptured testicular artery pseudoaneurysm resulting in hemorrhagic shock, which required massive transfusion protocol and vascular repair.

Conclusion: While endovascular access is relatively safe, patients can develop severe complications such as pseudoaneurysm development and subsequent rupture that may not be obviously apparent on physical exam. Because of this, clinicians must have a high index of suspicion for arterial injury, and risk stratification should be used when selecting appropriate candidates for prophylactic procedures.

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Conflict of interest statement

Conflicts of Interest: By the CPC-EM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. The authors disclosed none.

Figures

Image 1
Image 1
Significant swelling and ecchymosis to the scrotum with recent right femoral artery access site. Left side shows initial presentation, while right side shows progression with extension up the penile shaft two hours later.
Image 2
Image 2
Computed topography angiogram abdomen/pelvis showing 15-centimeter x 3-cm multilocular partially ruptured pseudoaneurysm of the testicular branches of the right external iliac artery involving the right scrotum with adjacent large hematoma and active extravagation of contrast as highlighted by the white arrows.
See this image and copyright information in PMC

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