Gastroduodenal artery aneurysm - an extremely rare but insidious cause of abdominal pain: a case report

Pan Afr Med J. 2024 Feb 20:47:77. doi: 10.11604/pamj.2024.47.77.42605. eCollection 2024.

Abstract

An arterial aneurysm is a localized weakening of the artery wall that results in pathological dilatation. All intra-abdominal artery aneurysms are labeled as visceral artery aneurysms (VAA), apart from the aorto-iliac artery aneurysms. VAA´s are rare, gastroduodenal artery aneurysms (GDAA), constituting 1.5% of visceral artery aneurysms. A woman in her early 80s´ presented with chronic epigastric pain, weight loss, and nausea. Conservative management was unsuccessful. Imaging revealed a GDAA, prompting endovascular coil embolization. Subsequent evaluation confirmed Polyarteritis Nodosa (PAN), treated with rituximab. The report underscores the diagnostic challenges, emphasizing the need for a multidisciplinary approach using imaging and angiography. GDAA's potential life-threatening rupture necessitates prompt intervention, as illustrated in this case. The rare association with PAN, although infrequent, underscores the importance of considering underlying etiologies in multiple visceral aneurysms. Early diagnosis and intervention are pivotal for this uncommon yet potentially lethal condition.

Keywords: Visceral aneurysms; case report; gastroduodenal artery aneurysm; refractory abdominal pain.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain* / etiology
  • Aged, 80 and over
  • Aneurysm* / complications
  • Aneurysm* / diagnosis
  • Angiography
  • Duodenum / blood supply
  • Duodenum / pathology
  • Embolization, Therapeutic* / methods
  • Female
  • Gastric Artery
  • Humans
  • Polyarteritis Nodosa* / complications
  • Polyarteritis Nodosa* / diagnosis
  • Rituximab / administration & dosage

Substances

  • Rituximab