Gastroduodenal Artery (GDA) Pseudoaneurysm as a Cause of Massive Upper Gastrointestinal (GI) Bleeding Years After Partial Gastrectomy
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View abstract on PubMed
Summary
This summary is machine-generated.Gastroduodenal artery (GDA) pseudoaneurysms are rare but life-threatening complications after gastric surgery. Successful treatment involves identifying the pseudoaneurysm via arteriogram and performing embolization for definitive bleeding control.
Area Of Science
- Gastroenterology
- Interventional Radiology
- Vascular Surgery
Background
- Gastroduodenal artery (GDA) pseudoaneurysm is a rare complication following gastric and pancreatic surgery.
- It often presents as severe gastrointestinal (GI) bleeding with a high mortality rate (up to 90%).
- Identifying prior gastrectomy is crucial for effective treatment, as endoscopic management frequently fails.
Purpose Of The Study
- To present a case of GDA pseudoaneurysm in a patient with a history of gastric surgery.
- To highlight the diagnostic and therapeutic challenges associated with this condition.
- To emphasize the importance of prompt diagnosis and definitive treatment.
Main Methods
- A 65-year-old male with a history of gastric surgery presented with severe GI bleeding.
- Initial upper endoscopy revealed a duodenal ulcer with spurting hemorrhage, followed by endoscopic therapy.
- Recurrent bleeding prompted a celiac arteriogram, which identified a GDA pseudoaneurysm, followed by successful embolization.
Main Results
- The patient experienced massive GI bleeding, initially treated endoscopically with recurrence.
- Celiac arteriography confirmed a pseudoaneurysm of the GDA.
- Successful embolization with helical coils led to cessation of bleeding and patient stabilization.
Conclusions
- GDA pseudoaneurysm should be suspected in patients with a history of gastrectomy, bypass, or pancreatectomy presenting with GI bleeding.
- Endoscopic interventions are often temporary, with angiography and embolization offering definitive treatment.
- While patients can be asymptomatic, the duodenum is the most common bleeding site; surgery is an option if embolization fails.
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