Rupture of pseudoaneurysm of the pancreaticoduodenal arcade after acute aortic dissection in a patient on anticoagulant therapy

Seiichi Taniai; Wataru Nagai; Hisashi Shimizu; Yutaka Masuda; Toshiaki Nitatori; Hideaki Yoshino

doi:10.1016/j.jccase.2010.12.003

Rupture of pseudoaneurysm of the pancreaticoduodenal arcade after acute aortic dissection in a patient on anticoagulant therapy

J Cardiol Cases. 2011 Jan 13;3(2):e103-e105. doi: 10.1016/j.jccase.2010.12.003. eCollection 2011 Apr.

Authors

Seiichi Taniai¹, Wataru Nagai¹, Hisashi Shimizu¹, Yutaka Masuda², Toshiaki Nitatori², Hideaki Yoshino¹

Affiliations

¹ Division of Cardiology, Department of Internal Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, Japan.
² Department of Radiology, Kyorin University School of Medicine, Tokyo,Japan.

Abstract

An 81-year-old woman on anticoagulant therapy after mechanical heart valve replacement was admitted because of acute aortic dissection. Anticoagulant therapy had to be continued with heparin even after admission. Gastrointestinal hemorrhage occurred suddenly and she developed hemorrhagic shock. Computed tomography findings suggested that the bleeding was due to rupture of a pseudoaneurysm of the pancreaticoduodenal arcade. After the site of bleeding was identified by angiography, hemorrhage was successfully controlled by embolization with coils. With the aging of the population, vascular complications of arteriosclerosis are likely to increase. This case report provides important insights that could be helpful for treating such patients.

Keywords: Aortic dissection; Duodenal bleeding; Pancreaticoduodenal arcade; Warfarin.