Jerzy Kossak, Jerzy Janik, Janusz Dębski, Ryszard Rytlewski, Artur Sałaciński
Med Sci Monit 2001; 7(4): CS759-761
A 35-year-old man presented to our emergency room with asymptomatic jaundice.A physical exam revealed a palpable mass with audible bruit in the epigastrium. Total serum bilirubinwas 21.7 mg%. A real time sonography/Doppler examination showed widening of the biliary tree (commonbile duct diameter of 13 mm) and a mass in the pancreatic head with turbulent flow. Arteriography ofthe celiac axis revealed a pseudoaneurysm of the gastroduodenal artery. A ligation of the gastroduodenalartery was performed surgically, and the aneurysmal cavity was explored and emptied. An intraoperativecholangiography showed slight stenosis of the common bile duct distally, and so a choledochojejunostomywas performed. The patient's recovery was uneventful. A follow-up angiogram revealed the short stumpof the gastroduodenal artery and no aneurysm or extravasation of dye. A follow-up ultrasound showed thecommon bile duct measuring 5.5 mm. The bilirubin level dropped to normal values. The patient was dischargedon 12 days after surgery. Ten months following surgery he was doing well. The pathology, diagnosis, andtreatment of such cases are briefly discussed.
Keywords: pseudoaneurysm of the gastroduodenal artery, obstructive jaundice