Galanakis Vasileios
Department of Gastroenterology, Ipswich Hospital NHS Trust, Ipswich, UK.
BMJ Case Rep. 2018 Apr 11;2018:bcr-2017-223882. doi: 10.1136/bcr-2017-223882.
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.
一名79岁男性因体重减轻接受择期检查入院。住院期间，他出现严重上腹部疼痛，初步血液检查显示淀粉酶急剧升高（>2000）且肝功能检查异常。增强CT血管造影显示十二指肠旁有一个大血肿，在腹膜后间隙扩散，源于胃十二指肠动脉区域一个2厘米的出血性假性动脉瘤。由于其基础合并症，他被认为不适合手术修复，遂进行了弹簧圈栓塞，止血成功。胃十二指肠动脉瘤罕见，占所有内脏动脉瘤的1.5%。它们可能是偶然发现，也可能表现为出血性休克、腹痛，很少表现为梗阻性黄疸或高淀粉酶血症。诊断通常通过血管造影进行。根据患者的身体状况和血流动力学稳定性，有多种治疗选择。
