Pseudoaneurysm of the gastroduodenal artery ruptured into the superior mesenteric vein in a patient with chronic pancreatitis.
We report the case of a patient with chronic pancreatitis that was complicated by the rare occurrence of a pseudoaneurysm of the gastroduodenal artery that ruptured into the superior mesenteric vein. The patient, a 65-year-old alcoholic man, suddenly experienced hematemesis. Gastroesophagoscopy revealed bleeding from esophageal varices; the hemorrhaging was controlled with sclerotherapy. Sonography identified a 2-cm round anechoic mass at the pancreatic head, and color Doppler imaging revealed turbulent arterial flow within the mass, leading us to the diagnosis of the pseudoaneurysm. CT and angiographic findings generally corresponded with those of sonography and confirmed our diagnosis. The pseudoaneurysm was treated successfully with embolization, and the patient was discharged 10 days after therapy. Follow-up sonography performed 2 months later confirmed the absence of blood flow within the lesion. Color Doppler sonography was very useful for diagnosing the pseudoaneurysm and planning its treatment, and we recommend its routine use in patients with chronic pancreatitis to avoid delays in diagnosing and treating such vascular complications.
Suzuki
Toshio
T
Center of Diagnostic Ultrasound, Red Cross Hospital, 222-1 Inashirosawa Saruta Kamikitade, Akita 010-1406, Japan.
Ishida
Hideaki
H
Komatsuda
Tomoya
T
Oyaké
Jinko
J
Miyauchi
Takaharu
T
Heianna
Joichi
J
Miyashita
Masahiro
M
D000368:Aged; D000437:Alcoholism / Q000150:complications; D017541:Aneurysm, False / Q000000981:diagnostic imaging* / Q000473:pathology*; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging* / Q000473:pathology*; D001158:Arteries / Q000473:pathology; D002908:Chronic Disease; D004386:Duodenum / Q000098:blood supply; D006801:Humans; D008297:Male; D010195:Pancreatitis / Q000150:complications*; D013270:Stomach / Q000098:blood supply; D018615:Ultrasonography, Doppler, Color