22 January 2016 : Case report
Mistake in diagnosis, Diagnostic / therapeutic accidents, Management of emergency care, Rare disease, Educational Purpose (only if useful for a systematic review or synthesis)Tomohide TakeiA, Michihiro SakaiABCDEF, Takuya SuzukiBCDF, Yuji YamamotoB, Yasuo OgasawaraB, Tetsuya ShimizuB, Jun ImaizumiAD, Ryosuke FuruyaAD, Hitoshi SekidoABE, Yasuhiro KoizumiABCD
Am J Case Rep 2016; 17:39-42
BACKGROUND: Ruptured aneurysms of the pancreaticoduodenal artery result in fatal hemorrhage and high mortality. Therefore, prompt diagnosis and treatment are required, but there are sometimes problems differentiating this specific diagnosis from other abdominal pathologies.
CASE REPORT: We encountered a rare case of a ruptured pancreaticoduodenal artery aneurysm with an atypical clinical presentation that simulated acute pancreatitis. A 71-year-old woman was admitted to the emergency department with abdominal pain in the left upper quadrant, a slightly elevated level of pancreatic amylase, and cholelithiasis on ultrasonography. With persistent pain and progressively decreasing hemoglobin level, computed tomography with contrast showed fluid collection in the subphrenic space, a retroperitoneal hematoma, and a pancreaticoduodenal artery aneurysm that appeared to originate from a branch of the SMA. Urgent angiography indicated spontaneous rupture of a pancreaticoduodenal artery aneurysm. Emergent surgery was undertaken, and a simple aneurysmectomy was successfully performed. The patient’s recovery was unremarkable. The prompt diagnosis of a pancreaticoduodenal artery aneurysm was difficult because the initial symptoms were vague and misleading in our case.
CONCLUSIONS: A high level of suspicion, rapid diagnostic capability, and prompt surgical or endovascular intervention, as well as effective teamwork in the emergency department, are critical to avoid the devastating consequences of a ruptured visceral artery aneurysm.
Keywords: Amylases - metabolism, Abdominal Pain - etiology, Aneurysm, Ruptured - surgery, Angiography, Arteries, Cholelithiasis - ultrasonography, Diagnosis, Differential, Duodenum - blood supply, Hemoglobins - analysis, Pancreas - blood supply, Pancreatitis - diagnosis
19 May 2022 : Case reportBilateral Emphysematous Pyelonephritis Associated with COVID Pneumonia: A Case Report
Am J Case Rep In Press; DOI: 10.12659/AJCR.936370
17 May 2022 : Case reportHigh-Frequency Oscillatory Ventilation for Refractory Hypoxemia in Severe COVID-19 Pneumonia: A Small Case ...
Am J Case Rep In Press; DOI: 10.12659/AJCR.936651
13 May 2022 : Case reportA case of exacerbation of haloperidol-induced rhabdomyolysis following the onset of COVID-19
Am J Case Rep In Press; DOI: 10.12659/AJCR.936589
20 May 2022 : Case reportDiagnostic Puzzle of Acute Ischemic Stroke Mimics – Seizure Versus Post-Stroke Recrudescence: A Case Report
Am J Case Rep In Press; DOI: 10.12659/AJCR.936826
19 May 2022 : Case reportExtremes of Anemia: The Lowest Hemoglobin Values Probably Ever Reported in the Pediatric Literature Attribu...
Am J Case Rep In Press; DOI: 10.12659/AJCR.936252
19 May 2022 : Case reportAcute Hepatitis with Positive Autoantibodies: A Case of Natalizumab-Induced Early-Onset Liver Injury
Am J Case Rep In Press; DOI: 10.12659/AJCR.936318
Most Viewed Current Articles
31 Dec 1969 : Case reportPenile Necrosis Associated with Local Intravenous Injection of Cocaine
Am J Case Rep 2022; 23:e935250
31 Dec 1969 : Case reportMyocarditis, Pulmonary Hemorrhage, and Extensive Myositis with Rhabdomyolysis 12 Days After First Dose of P...
Am J Case Rep 2022; 23:e934399
31 Dec 1969 : Case reportLipedema Can Be Treated Non-Surgically: A Report of 5 Cases
Am J Case Rep 2021; 22:e934406