Endovascular treatment of gastroduodenal artery pseudoaneurysm in a low-risk young female: Case report with literature review.

INTRODUCTION AND IMPORTANCE

Gastroduodenal artery (GDA) pseudoaneurysm is a rare but potentially life-threatening vascular anomaly, typically associated with pancreatitis, trauma, or previous surgery. Due to its high risk of rupture, early diagnosis and intervention are crucial. This case report highlights a unique presentation of GDA pseudoaneurysm in a 38-year-old female without traditional risk factors, emphasizing the importance of vigilance in atypical cases.

CASE PRESENTATION

A 38-year-old female with a history of cholecystectomy and chronic iron deficiency anemia presented with recurrent epigastric pain and anemia. Laboratory findings revealed significant microcytic hypochromic anemia. Initial imaging ruled out pancreatitis, but a contrast-enhanced computed tomography (CT) scan detected a GDA pseudoaneurysm with impending rupture. Given the high risk of hemorrhage, the patient underwent urgent endovascular embolization, successfully isolating the pseudoaneurysm. Post-procedural recovery was uneventful, with follow-up imaging confirming successful exclusion of the pseudoaneurysm. The patient's hemoglobin levels normalized, and she resumed daily activities without recurrence of symptoms, indicating a favorable long-term outcome.

CLINICAL DISCUSSION

GDA pseudoaneurysms are rare, accounting for only 1.5 % of visceral artery aneurysms, and typically occur in males over 50 years old with risk factors such as pancreatitis or alcohol abuse. This case is distinctive due to the patient's younger age, female gender, and absence of common etiologies. The successful use of endovascular embolization highlights its efficacy as a minimally invasive alternative to open surgery in managing visceral artery pseudoaneurysms.

CONCLUSION

This case underscores the importance of considering GDA pseudoaneurysm in patients with unexplained epigastric pain and anemia, even in the absence of traditional risk factors. Early imaging, prompt intervention, and postoperative monitoring are key to preventing catastrophic complications.