Gastroduodenal artery aneurysm- post traumatic pancreatic pseudocyst drainage - An interesting case
Zaka Ullah Jan, Mohammad Zarin, Sajid Ali, Abdul Majid
Khyber Teaching Hospital Peshawar, Pakistan
: J Surg Clin Pract
Abstract
Background and Aim: Pseudoaneurysms of the gastroduodenal artery (GDA) are rare and mostly associated with pancreatitis. However, they can occur as a possible complication following gastric or pancreaticsurgery and thus prior recognition and prompt treatment is mandatory. We reporta case of a ruptured GDA aneurysm in a patient who underwent roux-en-y-cystojejunostomy for trau-matic pancreatic pseudocyst and this has rarely been reported in the literature. Our patient presentedwith melena one month post operatively. CT Angiogram showed pseudoaneurysm of the GDA and theorigin of right gastroepiploic artery which was embolised. Our case highlights that GDA aneurysm mustbe considered in the differential for a patient who presents with melena following drainage of traumaticpancreatic pseudocyst and that it can be managed successfully with angioembolization. Case Presentation: A young boy was operated for traumatic pancreatic pseudocyst. One month later,he presented with the complaints of melena. Patient was resuscitated initially and then CT Angiogramwas planned that showed pseudo aneurysm of the GDA and the origin of right gastroepiploic artery. Theaneurysm was embolised and patient was sent home later on. On two months follow up the patient wasdoing well and had no episode of melena. Conclusion: GDA aneurysm are rare and should be suspected in a patient with GI hemorrhage aftersurgery for traumatic pancreatic pseudocyst. The investigation of choice is CT Angiography and endovas-cular angioembolization is the treatment modality of choice.
Biography
Zaka Ullah Jan has completed his MBBS at the age of 24 years from Khyber Medical College (Khyber Medical University) Peshawar. He is a General Surgery resident in the department of general surgery, Khyber Teaching Hospital Peshawar, a tertiary care hospital. He has interests in research work apart from clinical work and has published an interesting case report in IJSCR in January 2018.
E-mail: zuj_cck@yahoo.com
