title: Ruptured pancreaticoduodenal artery aneurysm with acute gangrenous cholecystitis: a case report and review of the literature.
abstract: We have experienced a very rare case of ruptured pancreaticoduodenal artery aneurysm with acute gangrenous cholecystitis. A 67-year-old male complaining of epigastralgia was admitted to our hospital. Ultrasound sonography demonstrated acute cholecystitis and cholecystolithiasis. Computed tomography scan showed the findings of acute cholecystitis and retroperitoneal mass. Emergency laparotomy revealed an acute gangrenous cholecystitis and a retroperitoneal hematoma around the second portion of the duodenum. Cholecystectomy was performed, however, the bleeding vessel was not identified. The patient bled again from the abdomen on the 6th postoperative day. A postoperative angiography indicated an inferior pancreaticoduodenal artery aneurysm. A resection of the aneurysm was performed following the angiography. Pancreaticoduodenal artery aneurysms are uncommon and ruptured pancreaticoduodenal artery aneurysms result in fatal hemorrhage and high mortality. We reviewed the previously reported cases and discussed the suitable and expeditious diagnosis and management of the pancreaticoduodenal artery aneurysms.
authors.affiliation: Department of Surgery, National Tokyo Medical Center, Tokyo, Japan.
authors.forename: Hiroya
authors.initials: H
authors.lastname: Takeuchi
authors.forename: Yoh
authors.initials: Y
authors.lastname: Isobe
authors.forename: Maya
authors.initials: M
authors.lastname: Hayashi
authors.forename: Takashi
authors.initials: T
authors.lastname: Matsui
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kinoshita
authors.forename: Atsushi
authors.initials: A
authors.lastname: Shimada
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Miyazawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Oishi
authors.forename: Shunji
authors.initials: S
authors.lastname: Ikeuchi
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Kubochi
authors.forename: Shingo
authors.initials: S
authors.lastname: Shima
mesh_terms: D000328:Adult; D000368:Aged; D017542:Aneurysm, Ruptured / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D001158:Arteries; D041881:Cholecystitis, Acute / Q000150:complications*; D004386:Duodenum / Q000098:blood supply*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000098:blood supply*; D014057:Tomography, X-Ray Computed