Published: 2020-04-23

A rare case of gastroduodenal artery aneurysm in a highly active antiretroviral therapy induced acute pancreatitis case presenting with lump in abdomen

Madhukar R. Gupta, Samridhi Goyal


Gastroduodenal artery (GDA) aneurysm is a rare but potentially fatal vascular disease, with chronic pancreatitis being reported as the commonest etiological factor. Rupture, which is not uncommon, carries a high risk of mortality. The typical patient with palpable epigastric mass, upper gastrointestinal bleeding and pain, may not present in the emergency and the lesion is often picked up incidentally on abdominal ultrasound or a computed tomography. We describe a critical case presenting with lump in abdomen which was found out to be gastroduodenal artery aneurysm on scanning, developing in a patient with recurrent highly active antiretroviral therapy (HAART) induced pancreatitis managed with transfemoral catheter embolization. The patient in question succumbed due to post procedure hepatic failure. The management of aneurysms since historic times have been challenging, the open procedures are being gradually replaced by endovascular techniques, which are yielding better results.


Acute pancreatitis, Endovascular, Gastroduodenal artery aneurysm, HAART induced, Lump in abdomen, Transfemoral aneurysm coiling

Full Text:



Kueper MA, Ludescher B, Koenigsrainer I, Kirschniak A, Mueller K, Wiskirchen J. Successful coil embolization of a ruptured gastroduodenal artery aneurysm. Vasc Endovasc Surg. 2007;41:568-71.

Habib N, Hassan S, Abdou R, Torbey E, Alkaied H, Maniatis T, et al. Gastroduodenal artery aneurysm, diagnosis, clinical presentation and management: a concise review. Ann Surg Innov Res. 2013;7:4.

Kaurich T. Drug-induced acute pancreatitis. Proc (Bayl Univ Med Cent). 2008;21:77-81.

Phan V, Thai S, Choun K, Lynen L, van Griensven J. Incidence of treatment-limiting toxicity with stavudine-based antiretroviral therapy in Cambodia: a retrospective cohort study. PLoS One. 2012;7:e30647.

Deterling RA Jr. Aneurysm of the visceral arteries. J Cardiovasc Surg. 1971;12:309-22.

Lee PC, Rhee RY, Gordon RY, Fung JJ, Webster MW. Management of splenic artery aneurysms: the significance of portal and essential hypertension. J Am Coll Surg. 1999;189:483-90.

Yeh TS, Jan YY, Jeng LB, Hwang TL, Wang CS, Chen MF. Massive extra-enteric gastrointestinal hemorrhage secondary to splanchnic artery aneurysms. Hepatogastroenterology. 1997;44:1152-6.

Batagini NC, El-Arousy H, Clair DG, Kirksey L. Open versus Endovascular Treatment of Visceral Artery Aneurysms and Pseudoaneurysms. Ann Vasc Surg. 2016;35:1-8.