Persisting bleeding from the duodenal ulcer in patients with occlusion of the celiac trunk: a case report

Introduction: Endoscopic measures have continued to be the primary procedures in the management of ulcer bleeding. Nevertheless, in cases of failed endoscopic hemostasis and re-bleedings, endovascular techniques have gradually gained increased acceptance as an alternative to surgery, allowing to avoid surgical intervention in some cases. Case report: A case of a 42-year-old patient presenting to the authors’ institution with massive bleeding from the duodenal ulcer, sprang from a pathologically enlarged gastroduodenal artery is reported. This vascular anomaly was a consequence of occlusion of the coeliac trunk (Dunbar syndrome), which was shown on an angio-CT scan. In spite of several endoscopic and endovascular measures, as well as three operations, the bleeding persistently recurred (a total of 6 episodes) and the patient eventually died. The article presents details of operative and endovascular treatments. Contemporary trends in management in cases of failed endoscopic interventions and re-bleedings form peptic ulcers are shown in the discussion.

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Jejunal Perforation as a Result of Massive Gastrointestinal Bleeding from a Duodenal Ulcer

Scottish Medical Journal ◽

10.1177/003693308402900209 ◽

1984 ◽

Vol 29 (2) ◽

pp. 109-110

Author(s):

J. N. Fox ◽

J. W. W. Thomson

Keyword(s):

Duodenal Ulcer ◽

Small Intestine ◽

Case Report ◽

Gastrointestinal Bleeding ◽

Upper Gastrointestinal Bleeding ◽

Massive Bleeding ◽

Spontaneous Perforation ◽

Massive Gastrointestinal Bleeding ◽

Upper Gastrointestinal

A complication of massive upper gastrointestinal bleeding is presented as a case report of a patient who developed a spontaneous perforation of the small intestine as a result of massive bleeding from a duodenal ulcer

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Intraoperative trans-esophageal echographic evaluation of the celiac artery flow after arcuate ligament resection in a case of Dunbar Syndrome. A case report

Journal of Clinical Images and Medical Case Reports ◽

10.52768/2766-7820/1137 ◽

2021 ◽

Vol 2 (3) ◽

Author(s):

Giacomo Coppalini ◽

◽

Enrico Giustiniano ◽

Fulvio Nisi ◽

Carlo Castoro ◽

...

Keyword(s):

Weight Loss ◽

Case Report ◽

Rare Disease ◽

Epigastric Pain ◽

Celiac Trunk ◽

Celiac Artery ◽

Median Arcuate Ligament ◽

Arcuate Ligament ◽

Dunbar Syndrome ◽

Artery Flow

Dunbar Syndrome (DS), also known as Median Arcuate Ligament (MAL) syndrome, is a rare disease in which the celiac trunk is compressed by a fibrous attachment at the diaphragmatic crura causing abdominal angina with a large spectrum of symptoms including nausea, vomiting, weight loss, and postprandial epigastric pain.

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Recurrent Peptic Ulcer Perforation: A Case Report

International Journal of Innovative Research in Medical Science ◽

10.23958/ijirms/vol07-i01/1329 ◽

2022 ◽

Vol 7 (01) ◽

pp. 62-65

Author(s):

Maather Al Abri, MD ◽

Ghaitha Al Mahruqi, MD ◽

Hani Al Qadhi, FRCSC

Keyword(s):

Duodenal Ulcer ◽

Peptic Ulcer ◽

Case Report ◽

Surgical Treatment ◽

Surgical Intervention ◽

Peptic Ulcer Perforation ◽

Perforated Duodenal Ulcer ◽

Peptic Ulcers ◽

Ulcer Perforation

Background: Refractory peptic ulcers are ulcers in the stomach or duodenum that do not heal after eight to twelve weeks of medical/surgical treatment or those that are associated with complications despite medical tssreatment. We herein present a case of a 44 year old man with a recurrent perforated duodenal ulcer requiring emergent surgical intervention.

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Absence of the celiac trunk and anomalous very low origin of the common hepatic artery arising independently from the abdominal aorta just above aortic bifurcation in patient undergoing radical pancreaticoduodenectomy

Surgical and Radiologic Anatomy ◽

10.1007/s00276-020-02666-6 ◽

2021 ◽

Author(s):

Sławomir Mrowiec ◽

Robert Król ◽

Beata Jabłońska

Keyword(s):

Computed Tomography ◽

Abdominal Aorta ◽

Pancreatic Head ◽

Celiac Trunk ◽

Vascular Anomaly ◽

Ampullary Adenocarcinoma ◽

Ampullary Tumor ◽

Liver Transplantations ◽

Angio Ct ◽

Enhanced Computed Tomography

Abstract Purpose Knowledge of anomalies of the celiac trunk is very important during various surgical procedures (such as pancreatic and gastric resections including Appleby operation, liver resections and liver transplantations) and as well as radiologic procedures (such as chemoembolization of pancreatic and hepatic tumors). Methods A 77-years-old woman was admitted to our department for surgical treatment of ampullary adenocarcinoma G2 confirmed in endoscopic retrograde cholangiopancreatography (ERCP) with papillotomy and ampullary biopsy. In the contrast-enhanced computed tomography, the ampullary tumor was not visible, but the main pancreatic duct within pancreatic head and isthmus was dilated (indirect radiological tumor signs). An absence of the celiac trunk (CT) was established via computed tomography. Therefore, computed tomography-based angiography (angio-CT) of the abdominal aorta (AA) was performed before operation. Results Angio-CT confirmed an extremely rare vascular anomaly: an absence of CT. The left gastric (LGA), splenic (SA), and common hepatic (CHA) arteries connected above origin of the superior mesenteric artery (SMA) from the AA. Pylorus-preserving pancreaticoduodenectomy (PD) was performed. This anomaly was also confirmed intraoperatively. The postoperative course was uneventful and the patient was discharged on postoperative day 10. There were no signs of recurrence of the tumor during the 6 months follow-up. Conclusion The proper preoperative identification of anomalies within major abdominal vessels and its relationship to the tumor is very important to avoid intraoperative vascular injury and major postoperative complications.

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Duodenal Ulcer With Multiple Complications: Case Report

Gastroenterology ◽

10.1016/s0016-5085(19)36611-9 ◽

1950 ◽

Vol 16 (1) ◽

pp. 259-261 ◽

Cited By ~ 1

Author(s):

Elmer W. Heffernon ◽

Allen C. Johnson

Keyword(s):

Duodenal Ulcer ◽

Case Report

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Multiple Cerebral Aneurysm - Case Report

Romanian Neurosurgery ◽

10.2478/romneu-2014-0037 ◽

2014 ◽

Vol 21 (3) ◽

pp. 279-282 ◽

Cited By ~ 1

Author(s):

C. Kakucs ◽

I. St. Florian

Keyword(s):

Case Report ◽

Carotid Artery ◽

Internal Carotid Artery ◽

Ct Scan ◽

Cerebral Aneurysm ◽

Internal Carotid ◽

Neurological Status ◽

Posterior Communicating Artery ◽

Nuchal Rigidity ◽

Angio Ct

Abstract This 41-years-old female presented with somnolence, confusion and nuchal rigidity. Preoperative angio-CT scan showed two aneurysm located on both internal carotid artery (ICA) at the site of posterior communicating artery (PComA). During surgery we discovered another dilatation on the origin of left ophtalmic artery that proves to be an infundibullum. We clipped the two communicating posterior aneurysm from the left side and the ophtalmic infundibullum was wrapped. Seven days after surgery the neurological status was improved and she was transferred to the Neurological department.

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EFFICACY OF INITIAL AND PERMANENT HEMOSTASIS OF THE ENDOSCOPIC HEMOCLIP METHOD COMBINED WITH HIGH-DOSE INFUSION OF PROTON PUMP INHIBITOR IN PATIENTS WITH PEPTIC ULER BLEEDING

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2018.2.2 ◽

2018 ◽

pp. 15-21

Author(s):

Hieu Tam Huynh ◽

Dang Quy Dung Ho

Keyword(s):

Peptic Ulcer ◽

Success Rate ◽

Endoscopic Hemostasis ◽

Ulcer Bleeding ◽

Injection Sclerotherapy ◽

High Dose ◽

Peptic Ulcers ◽

Peptic Ulcer Bleeding ◽

Bleeding Peptic Ulcers ◽

Hemostatic Therapy

Background: Peptic ulcer bleeding is one of the common medical emergencies. The hemostatic efficacy of endoscopic therapeutic modalities has been reported in many studies and frequently has been found to exceed 90%. Four groups of modalities are used in the endoscopic management of bleeding peptic ulcers: thermal probe methods, injection sclerotherapy, local spray methods, and mechanical hemostatic therapy. The endoscopic hemoclip method is a safe and effective hemostatic therapy for managing bleeding peptic ulcers. Objective: To determine the success rate of hemoclip in endoscopic hemostasis. Patients and methods: Clinical intervention study on 36 patients with peptic ulcer bleeding admitted in Can Tho Central General Hospital from May 2012 to November 2014. All the patients underwent emergency endoscopy for hemostasis by hemoclip and high-dose PPI use. Results: The success rate of initial hemostasis was 97.2%, and permanent hemostasis was 91.7%. The rates of rebleeding, surgery, mortality were 11.1%, 5.6%, 2.8%, respectively. Conclusion: Endoscopic hemostasis therapy by clipping combined with high- dose PPI is an effective, relatively safe treatment for peptic ulcer bleeding. Key words: Peptic ulcer bleeding, hemoclip, endoscopic hemostasis therapy

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