Gastroduodenal Artery Pseudoaneurysm Causing Obstructive Jaundice

• Published in: The Ochsner journal Vol. 21; no. 1; pp. 104 - 107
• Main Authors: Chapman, Brett M, Bolton, John S, Gioe, Scott M, Conway, W Charles
• Format: Journal Article
• Language: English
• Published: United States Academic Division of Ochsner Clinic Foundation 2021
• Subjects: Case Reports and Clinical Observations; pancreatitis; aneurysm–false; jaundice–obstructive; Aneurysm
• ISSN: 1524-5012; 1524-5012
• DOI: 10.31486/toj.19.0110

Visceral artery aneurysms and pseudoaneurysms are uncommon phenomena with a high mortality rate in cases of rupture. These rare vascular pathologies are usually asymptomatic and are therefore generally discovered incidentally on computed tomography or magnetic resonance imaging examination. Current therapeutic options have trended toward a minimally invasive approach because of evolving endovascular treatment options, with open operations typically reserved for cases of intraabdominal hemorrhage.
We describe a case of gastroduodenal artery pseudoaneurysm manifesting as obstructive jaundice and pancreatitis because of extrahepatic compression of the common bile duct and pancreatic duct by mass effect. Open repair was ultimately required secondary to arterial anatomy that was not amenable to any endovascular treatment approach.
While endovascular options are the preferred treatment modality for visceral artery aneurysms and pseudo-aneurysms, some cases require definitive open repair for a variety of reasons, including unsuitable anatomy.