A case report: encapsulated hematoma, caused by gastroduodenal artery saccular aneurism rupture, and managed using endovascular coiling technique

Abstract

Introduction. Visceral artery aneurysms are rarely spotted entities. Their incidence rate is from 0.01 to 0.2% and their prevalence rate is of 1%. Also, these kinds of entities affect 2% to the gastroduodenal artery. Its riskiest complication is the aneurysmal rupture, and it is vital to run an early diagnosis due to the high mortality rates this complication might have (rupture mortality rates are up to 70%). For this reason, endovascular coiling might be an effective and safe technique for managing visceral aneurysms, as this technique has proved excellent results and remarkable diminishments in complications associated with the entity control. Objective. To describe clinical and imaging characteristics, and endovascular therapeutics deployment within a gastroduodenal artery aneurysm study case. Case presentation. A 62-year-old man, with no previous clinical history of the condition, enters to the emergency room because of a sudden syncopal episode accompanied by nausea, abdominal pain, diarrheal stools and malaise. When the patient is examined, the medical team noticed that in spite he was in an overall good health condition, he was mildly dehydrated, showed generalized paleness, and complained about mild pain in the right hemiabdomen area when performing superficial abdominal palpation. Consequently, a high-contrast computerized axial tomography (High-Contrast CAT scan) revealed the rupture of a secondary hematoma located on the gastroduodenal arteria. Endovascular management is performed using arterial puncture techniques in the right brachial artery. After this procedure, arterial bleeding was managed using endovascular coil embolization. When the physical intervention concluded, the patient evolved favorably and was discharged two days later. Conclusions. Endovascular management using coiling embolization techniques is one of the most recent and effective surgical approaches. It has proved to reduce mortality rates among patients with aneurysms located within the gastrointestinal area. [GalvisMéndez M, Sánchez-Rodríguez ML, Cepeda-Bareño DF, Santander-Landazabal JD. A case report: encapsulated hematoma, caused by gastroduodenal artery saccular aneurism rupture, and managed using endovascular coiling technique. MedUNAB. 2018;21(1):130-137 doi:10.29375/01237047.2781].