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Case Reports in Surgery
Volume 2015, Article ID 370937, 3 pages
http://dx.doi.org/10.1155/2015/370937
Case Report

A Challenging Case of a Large Gastroduodenal Artery Pseudoaneurysm after Surgery of a Peptic Ulcer

1Division of Hepatobiliopancreatic Surgery, Department of General Surgery, San Carlos Clinic Hospital of Madrid, Madrid, Spain
2Unit of Abdomen Imaging Diagnosis and Interventional Radiology, Department of Radiology and Imaging, San Carlos Clinic Hospital of Madrid, Madrid, Spain

Received 28 September 2014; Accepted 14 December 2014

Academic Editor: Muthukumaran Rangarajan

Copyright © 2015 Rocio Santos-Rancaño et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We report a 48-year-old man in whom a chronic postbulbar duodenal ulcer destroyed much of the back wall of the duodenum and gastroduodenal artery causing pseudoaneurysm. The lesion was found and evaluated by contrast-enhanced computed tomography (that revealed a large pseudoaneurysm of 83 mm 75 mm in diameter) and by angiography and then treated with transcatheter embolization leading to a complete resolution of the lesion. The case is rare and important for several reasons. First, we demonstrate that pseudoaneurysm of the gastroduodenal artery caused by a duodenal ulcer can occur and present a diagnostic challenge (as far as we know, only three cases have been reported previously in the literature). Second, this case report focuses on the importance of ligation of the gastroduodenal artery when bleeding of peptic ulcers occurs. Additionally, we present an overview of the relevant literature.