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PICTURES IN CLINICAL MEDICINE
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Ruptured Pseudoaneurysm in the Inferior Pancreaticoduodenal Artery Satoru Yanagaki 1, Yasuchika Yamamoto 2 and Tasuku Nagasawa 1 Key words: idiopathic retroperitoneal bleeding, inferior pancreaticoduodenal artery pseudoaneurysm, coil embolization
(Intern Med 55: 3233-3234, 2016) (DOI: 10.2169/internalmedicine.55.7306)
Picture.
A previously healthy 55-year-old man presented to the emergency room with abdominal pain. He had noticed abdominal pain in the right upper quadrant suddenly after a coughing. We performed abdominal computed tomography (CT), which showed idiopathic retroperitoneal bleeding, but the source of bleeding was unclear (Picture a). We hesitated to perform surgery because his clinical condition has im-
proved after being treated with fasting and fluid replacement. Five days after admission, his abdominal pain had worsening and became severe, so we performed abdominal CT again, which demonstrated a pseudoaneurysm in the inferior pancreaticoduodenal artery (Picture b). We therefore performed coil embolization (Picture c and d). After embolization, his clinical condition quickly improved. He has been
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Department of Nephrology, Japanese Red Cross Ishinomaki Hospital, Japan and ２ Department of Gastroenterology, Japanese Red Cross Ishinomaki Hospital, Japan Received for publication February 23, 2016; Accepted for publication March 2, 2016 Correspondence to Dr. Satoru Yanagaki, [email protected]
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Intern Med 55: 3233-3234, 2016
DOI: 10.2169/internalmedicine.55.7306
symptom-free since being discharged from the hospital. The authors state that they have no Conflict of Interest (COI).
References 1. Kikawa Y, Ikeda H, Nakamoto Y, et al. A Case of Pancreaticoduodenal Artery Aneurysm Ruptured into the Common Bile Duct. Nihon Shokaki Geka Gakkai Zasshi (Jpn J Gastroenterol Surg) 40:
307-312, 2007 (in Japanese, Abstract in English). 2. Suzuki N, Nakao K, Narita K. A case of retroperitoneal hematoma of unknown cause. Nihon Shokaki Geka Gakkai Zasshi (Jpn J Gastroenterol Surg) 39: 358-362, 2006 (in Japanese, Abstract in English). The Internal Medicine is an Open Access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/ by-nc-nd/4.0/).
Ⓒ 2016 The Japanese Society of Internal Medicine http://www.naika.or.jp/imonline/index.html
3234
PICTURES IN CLINICAL MEDICINE
□
Ruptured Pseudoaneurysm in the Inferior Pancreaticoduodenal Artery Satoru Yanagaki 1, Yasuchika Yamamoto 2 and Tasuku Nagasawa 1 Key words: idiopathic retroperitoneal bleeding, inferior pancreaticoduodenal artery pseudoaneurysm, coil embolization
(Intern Med 55: 3233-3234, 2016) (DOI: 10.2169/internalmedicine.55.7306)
Picture.
A previously healthy 55-year-old man presented to the emergency room with abdominal pain. He had noticed abdominal pain in the right upper quadrant suddenly after a coughing. We performed abdominal computed tomography (CT), which showed idiopathic retroperitoneal bleeding, but the source of bleeding was unclear (Picture a). We hesitated to perform surgery because his clinical condition has im-
proved after being treated with fasting and fluid replacement. Five days after admission, his abdominal pain had worsening and became severe, so we performed abdominal CT again, which demonstrated a pseudoaneurysm in the inferior pancreaticoduodenal artery (Picture b). We therefore performed coil embolization (Picture c and d). After embolization, his clinical condition quickly improved. He has been
１
Department of Nephrology, Japanese Red Cross Ishinomaki Hospital, Japan and ２ Department of Gastroenterology, Japanese Red Cross Ishinomaki Hospital, Japan Received for publication February 23, 2016; Accepted for publication March 2, 2016 Correspondence to Dr. Satoru Yanagaki, [email protected]
3233
Intern Med 55: 3233-3234, 2016
DOI: 10.2169/internalmedicine.55.7306
symptom-free since being discharged from the hospital. The authors state that they have no Conflict of Interest (COI).
References 1. Kikawa Y, Ikeda H, Nakamoto Y, et al. A Case of Pancreaticoduodenal Artery Aneurysm Ruptured into the Common Bile Duct. Nihon Shokaki Geka Gakkai Zasshi (Jpn J Gastroenterol Surg) 40:
307-312, 2007 (in Japanese, Abstract in English). 2. Suzuki N, Nakao K, Narita K. A case of retroperitoneal hematoma of unknown cause. Nihon Shokaki Geka Gakkai Zasshi (Jpn J Gastroenterol Surg) 39: 358-362, 2006 (in Japanese, Abstract in English). The Internal Medicine is an Open Access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/ by-nc-nd/4.0/).
Ⓒ 2016 The Japanese Society of Internal Medicine http://www.naika.or.jp/imonline/index.html
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