Ashraf Muhammad Farhan, Vipani Aarshi, Batool Asra
Department of Internal Medicine, Albany Medical Center, Albany, NY, USA.
Cedars Sinai Medical Center, Los Angeles, CA, USA.
J Med Cases. 2021 Nov;12(11):464-467. doi: 10.14740/jmc3786. Epub 2021 Nov 5.
Gastric outlet obstruction can occur secondary to intrinsic or extrinsic pathology. Historically peptic ulcer disease was the most common cause of gastric outlet obstruction but now malignancy-associated disease process is more common. Gastric outlet obstruction from mucosal ischemia caused by embolization of gastroduodenal artery is unheard of. This is due to the extensive blood supply of the stomach. We present an unusual presentation of gastric outlet obstruction in a patient with recent embolization of pancreatitis-induced pseudoaneurysm of the gastroduodenal artery. The diagnosis was confirmed with esophagogastroduodenoscopy, computed tomography, and upper gastrointestinal series. The case was managed conservatively with a clear liquid diet and proton pump inhibitors. Repeat upper endoscopies at 1 and 6 months after presentation confirmed disease resolution. No guidelines exist on the management of such cases due to the rarity of the disease.
胃出口梗阻可继发于内在或外在病变。历史上，消化性溃疡病是胃出口梗阻最常见的原因，但现在与恶性肿瘤相关的疾病过程更为常见。由胃十二指肠动脉栓塞引起的黏膜缺血导致的胃出口梗阻闻所未闻。这是由于胃的血液供应丰富。我们报告了一例近期因胰腺炎诱发的胃十二指肠动脉假性动脉瘤栓塞而出现胃出口梗阻的不寻常病例。通过食管胃十二指肠镜检查、计算机断层扫描和上消化道造影确诊。该病例采用清流食和质子泵抑制剂进行保守治疗。就诊后1个月和6个月重复进行上消化道内镜检查证实病情缓解。由于这种疾病罕见，目前尚无关于此类病例管理的指南。
