[Acute right-sided upper abdominal pain in a 46-year-old woman]

Internist (Berl). 2018 Feb;59(2):199-204. doi: 10.1007/s00108-017-0293-1.
[Article in German]

Abstract

A 46-year-old woman presented with acute abdominal pain in the right upper quadrant. Esophagogastroduodenoscopy revealed a duodenal stenosis within the horizontal part of the duodenum. Based on the findings of abdominal computed tomography (CT), endosonography, Doppler duplex sonography and angiography, the diagnosis of an aneurysm of a branch of the inferior pancreaticoduodenal artery was established. This arterial branch was part of a collateral circulation between the superior mesenteric artery and the proper hepatic artery caused by obturation of the celiac artery. The symptomatic duodenal stenosis was the result of a local hematoma due to prior rupture of an aneurysm. After successful coiling of the afferent vessels to the aneurysm follow-up examinations showed progredient resorption of the hematoma and the patient was free of complaints.

Keywords: Aneurysm, visceral artery; Coiling; Duodenum, stenosis; Inferior pancreaticoduodenal artery; Mesenteric artery, superior.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain / diagnosis
  • Abdominal Pain / etiology*
  • Abdominal Pain / therapy
  • Acute Pain / etiology*
  • Aneurysm, Ruptured / complications*
  • Aneurysm, Ruptured / diagnosis
  • Aneurysm, Ruptured / therapy
  • Duodenal Obstruction / complications*
  • Duodenal Obstruction / diagnosis
  • Duodenum / blood supply*
  • Embolization, Therapeutic
  • Female
  • Hematoma / complications
  • Hematoma / diagnosis
  • Hematoma / therapy
  • Humans
  • Middle Aged
  • Pancreas / blood supply*