A Case of Rupture of a Pseudoaneurysm in the Gastroduodenal Artery Two Months after Gastrectomy

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  • KAWAKAMI Koki
    Department of Surgery, Unnan City HospitalDepartment of Surgery, Matsue Red Cross Hospital
  • SATO Yoshitoshi
    Department of Surgery, Unnan City HospitalDepartment of Surgery, Matsue Red Cross Hospital
  • MORIWAKI Yoshihiro
    Department of Surgery, Unnan City HospitalDepartment of Surgery, Matsue Red Cross Hospital
  • OTANI Jun
    Department of Surgery, Unnan City HospitalDepartment of Surgery, Matsue Red Cross Hospital

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Other Title
  • 胃切除術2カ月後に生じた胃十二指腸動脈仮性動脈瘤破裂の1例

Abstract

<p>An 83-year-old woman underwent distal gastrectomy (D2 dissection, Billroth I reconstruction) for gastric cancer and was discharged 15 days after surgery without complications. She was diagnosed with pT2 (MP) N3bM0, pStage III B and was receiving adjuvant chemotherapy with TS-1. On the 65th postoperative day, she suddenly developed hematemesis and melena. A contrast-enhanced CT scan revealed bleeding from a pseudoaneurysm in the gastroduodenal artery, and arterial embolization was performed. Bleeding due to rupture of a pseudoaneurysm after gastrectomy is rare, and most cases occur secondary to suture failure or pancreatic juice leakage within a month after surgery. On the other hand, there are some reports that heat generated by devices such as ultrasonic coagulator and incision causes vascular damage and pseudoaneurysm formation. Perioperative management and appropriate operation of the device are considered important, taking into account the possibility of ruptured pseudoaneurysm as a complication of gastrectomy.</p>

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