Alhasan Abdulaziz, Khan Patan M
Department of Internal Medicine, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia.
Ann Saudi Med. 2009 Sep-Oct;29(5):393-6. doi: 10.4103/0256-4947.55171.
We present a rare case of gastric outlet obstruction due to compression of the duodenum by a pancreaticoduodenal artery (PDA) aneurysm 2.5 cm in diameter, in a 43-year-old man from Saudi Arabia who presented with persistent vomiting and epigastric pain. The initial investigations and blood works were negative, and esophagogastroduodenoscopy (EGD) was unremarkable. A CT abdomen demonstrated a mass around the duodenum and dilatation of the stomach, and CT angiography showed the PDA aneurysm. The patient was stabilized and then referred to a tertiary center for embolization. Our case demonstrates a diagnostic challenge that physicians may encounter in patients who present with vomiting and epigastric pain.
我们报告了一例罕见的胃出口梗阻病例,病因是一名来自沙特阿拉伯的43岁男性患者的十二指肠被直径2.5厘米的胰十二指肠动脉(PDA)动脉瘤压迫。该患者出现持续呕吐和上腹部疼痛。初步检查和血液检查结果均为阴性,食管胃十二指肠镜检查(EGD)也无异常发现。腹部CT显示十二指肠周围有肿块以及胃扩张,CT血管造影显示了PDA动脉瘤。患者病情稳定后,被转诊至三级医疗中心进行栓塞治疗。我们的病例表明,对于出现呕吐和上腹部疼痛的患者,医生可能会面临诊断挑战。