Ruptured Gastroduodenal Artery Aneurysm Presenting As Upper Gastrointestinal Bleed

Abstract

Gastroduodenal artery (GDA) aneurysm is a very rare condition out of all vascular aneurysms. It represents only 1.5% of reported splanchnic artery aneurysms.This is a case of a 37-year-old man who presented with upper gastrointestinal bleeding.oesophagogastroduodenoscopy revealed an ulcer at first part of duodenum.During intervention towards the ulcer, it was massively bleed and unable to be controlled by endoscopic mean. Emergency angiogram was done and suprisingly showed an aneurysm of the gastroduodenal artery which ran below the ulcer.It was successfully embolized and thebleeeding arrested.The discussion is directed towards detection of rare causes of upper gastrointestinal bleeding and the best modalities to treat this condition either by endoscopic mean , interventional radiology or surgery. Keyword : gastroduodenal artery aneurysm ; upper gastrointestinal bleeding I. Introduction Aneurysms of the splanchnic arteries are rare with splenic artery aneurysm being the most common location (10.4%), while gastroduodenal artery (GDA) aneurysm represents only 1.5% of of more than 3000 reported splanchnic artery aneurysms reported since 1960's. 1,2 Most of the GDA aneurysms described in the literature are pseudoaneurysms associated with pancreatitis. 3 Rupture of GDA aneurysm is usually a dramatic manifestation of hemorrhagic shock associated with high mortality. 4 We present a case of a GDA aneurysm rupture that was diagnosed incidentally during endovascular intervention for a patient with upper GI bleed.