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CC BY 4.0 · Journal of Gastrointestinal and Abdominal Radiology
DOI: 10.1055/s-0044-1801777
Case Report

Spectrum of Atypical Vascular Pathologies Mimicking Duodenal Submucosal Tumor and Directly Bleeding into Duodenal Lumen: A Case Series Study with Management by Interventional Radiology

Srijit Saha 
1   Department of Radiology and Interventions, The CK Birla Hospitals, Calcutta Medical Research Institute, Kolkata, West Bengal, India
,
Avik Bhattacharyya
1   Department of Radiology and Interventions, The CK Birla Hospitals, Calcutta Medical Research Institute, Kolkata, West Bengal, India
,
Sourav Tripathy
1   Department of Radiology and Interventions, The CK Birla Hospitals, Calcutta Medical Research Institute, Kolkata, West Bengal, India
,
Arindam Bhandari
1   Department of Radiology and Interventions, The CK Birla Hospitals, Calcutta Medical Research Institute, Kolkata, West Bengal, India
,
Sounak Paul 
1   Department of Radiology and Interventions, The CK Birla Hospitals, Calcutta Medical Research Institute, Kolkata, West Bengal, India
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Abstract

Gastrointestinal (GI) bleeding is a life-threatening medical condition and requires a multidisciplinary approach for proper diagnosis and management. Various vascular pathologies in and around the duodenum can lead to bleeding into the duodenum either directly or through the bile duct or pancreatic duct, and the patients present with melena or hematemesis. Sometimes, these lesions present as a submucosal tumor with active bleeding or present like a bleeding duodenal ulcer. These cases must be investigated thoroughly before any endoscopic interventions; otherwise, patient may land up in life-threatening situations. Radiology plays an important role in both diagnosing and treating these vascular lesions. Here, we have presented a few cases where the vascular pathologies mimicking duodenal submucosal tumors caused direct bleeding into the duodenum.

Keywords

duodenal bleed - duodenal submucosal tumor - pseudoaneurysm - case series

Ethics Approval and Consent to Participate

The procedure described was in accordance with the institutional ethical guidelines and conform to the World Medicine Association declaration of Helsinki regarding the ethical principles for medical research involving human subjects.


Consent for Publication

Written informed consent was obtained from the patient and the patient's relatives for publication of the article.




Publication History

Article published online:
13 January 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Wilkins T, Khan N, Nabh A, Schade RR. Diagnosis and management of upper gastrointestinal bleeding. Am Fam Physician 2012; 85 (05) 469-476
    PubMedSearch in Google Scholar
  • 2 Krishna Kandarpa. John E. Aruny. Handbook of Interventional Radiologic Procedures. (2002) ISBN: 9780781723589
  • 3 Motoo Y, Okai T, Ohta H. et al. Endoscopic ultrasonography in the diagnosis of extraluminal compressions mimicking gastric submucosal tumors. Endoscopy 1994; 26 (02) 239-242
    Thieme ConnectPubMedSearch in Google Scholar
  • 4 Okano A, Takakuwa H, Matsubayashi Y. Aortoduodenal fistula resembling a submucosal tumor due to penetration of abdominal aortic aneurysm. Intern Med 2005; 44 (08) 904-905
    CrossrefPubMedSearch in Google Scholar
  • 5 al-Jeroudi A, Belli AM, Shorvon PJ. False aneurysm of the pancreaticoduodenal artery complicating therapeutic endoscopic retrograde cholangiopancreatography. Br J Radiol 2001; 74 (880) 375-377
    CrossrefPubMedSearch in Google Scholar
  • 6 Hügel HE, Oser W, Bodner E. Aneurysm of the proper hepatic artery as a rare source of upper gastrointestinal bleeding. Gastrointest Radiol 1986; 11 (02) 158-160
    CrossrefPubMedSearch in Google Scholar
  • 7 Aboujaoude M, Noel B, Beaudoin M, Ghattas G, Lalonde L, Oliva VL. The Bao Bui. Pseudoaneurysm of the proper hepatic artery with duodenal fistula appearing as a late complication of blunt abdominal trauma. J Trauma 1996; 40 (01) 123-125
    CrossrefPubMedSearch in Google Scholar
  • 8 Sjödahl R, Wetterfors J. Lysolecithin and lecithin in the gallbladder wall and bile; their possible roles in the pathogenesis of acute cholecystitis. Scand J Gastroenterol 1974; 9 (06) 519-525
    CrossrefPubMedSearch in Google Scholar
  • 9 Pickhardt PJ, Bhalla S, Balfe DM. Acquired gastrointestinal fistulas: classification, etiologies, and imaging evaluation. Radiology 2002; 224 (01) 9-23
    CrossrefPubMedSearch in Google Scholar
  • 10 Horton KM, Smith C, Fishman EK. MDCT and 3D CT angiography of splanchnic artery aneurysms. AJR Am J Roentgenol 2007; 189 (03) 641-647
    CrossrefPubMedSearch in Google Scholar
  • 11 Jesinger RA, Thoreson AA, Lamba R. Abdominal and pelvic aneurysms and pseudoaneurysms: imaging review with clinical, radiologic, and treatment correlation. Radiographics 2013; 33 (03) E71-E96
    CrossrefPubMedSearch in Google Scholar