Amro Alhareth M, Deeb Salahaldeen, Jaber Mohanad, Maraqa Mohammed, Sabarna Waled, Alhusseini Rajai
Faculty of Medicine, Al-Quds University, Jerusalem, Palestine.
Faculty of Medicine, Al-Quds University, Jerusalem, Palestine.
Int J Surg Case Rep. 2025 Jun;131:111346. doi: 10.1016/j.ijscr.2025.111346. Epub 2025 Apr 23.
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.
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.
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.
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.
胃十二指肠动脉（GDA）假性动脉瘤是一种罕见但可能危及生命的血管异常，通常与胰腺炎、创伤或既往手术有关。由于其破裂风险高，早期诊断和干预至关重要。本病例报告强调了一名38岁无传统危险因素女性患者中GDA假性动脉瘤的独特表现，强调了在非典型病例中保持警惕的重要性。
一名有胆囊切除术和慢性缺铁性贫血病史的38岁女性，出现反复上腹部疼痛和贫血。实验室检查发现显著的小细胞低色素性贫血。初始影像学检查排除了胰腺炎，但增强计算机断层扫描（CT）检测到一个即将破裂的GDA假性动脉瘤。鉴于出血风险高，患者接受了紧急血管内栓塞治疗，成功隔离了假性动脉瘤。术后恢复顺利，随访影像学检查证实假性动脉瘤已成功排除。患者血红蛋白水平恢复正常，她恢复了日常活动，症状未复发，表明长期预后良好。
GDA假性动脉瘤罕见，仅占内脏动脉瘤的1.5%，通常发生在50岁以上有胰腺炎或酗酒等危险因素的男性中。该病例具有独特性，因为患者年龄较轻、为女性且无常见病因。血管内栓塞的成功应用突出了其作为治疗内脏动脉假性动脉瘤的微创替代开放手术的有效性。
本病例强调了即使在没有传统危险因素的情况下，对于不明原因的上腹部疼痛和贫血患者也应考虑GDA假性动脉瘤。早期影像学检查、及时干预和术后监测是预防灾难性并发症的关键。
