Belmir Hicham, Tijani Youssef, Kettani Chafik El, Ghanmi Adil El, Chtata Hassan, Taberkant Mustapha
Département de Chirurgie Vasculaire, Université Mohammed VI des Sciences de la Santé, Casablanca, Maroc.
Département d'Anesthésie-Réanimation, Université Mohammed VI des Sciences de la Santé, Casablanca, Maroc.
Pan Afr Med J. 2020 Nov 17;37:244. doi: 10.11604/pamj.2020.37.244.22380. eCollection 2020.
Gastroduodenal artery aneurysm is a rare vascular lesion, asymptomatic in the majority of cases. However, ruptured aneurysm is associated with poor prognosis and mortality can achieve a 40% rate. We here report the case of an 83-year-old patient with abrupt onset of non-specific abdominal pain associated with hematemesis. Endoscopy showed beating formation compressing the duodenal bulb with active bleeding. Abdominal computed tomography (CT) scan was performed which objectified gastro duodenal artery aneurysms involving the artery ostium and making endovascular treatment impossible to perform. Thus, the patient underwent open surgery based on flattening associated with aneurysm exclusion and then complemented by bulb plasty. Post-operative CT scan confirmed total exclusion of the aneurysm with preservation of hepatic circulation.
胃十二指肠动脉动脉瘤是一种罕见的血管病变,大多数情况下无症状。然而,动脉瘤破裂与预后不良相关,死亡率可达40%。我们在此报告一例83岁患者,突发非特异性腹痛并伴有呕血。内镜检查显示有搏动性肿物压迫十二指肠球部并伴有活动性出血。进行了腹部计算机断层扫描(CT),结果显示胃十二指肠动脉动脉瘤累及动脉开口,无法进行血管内治疗。因此,患者接受了基于动脉瘤切除并辅以球囊成形术的开放手术。术后CT扫描证实动脉瘤已完全切除,肝循环得以保留。