case_images: PMC11192190_01
case_images: CT angiography of the abdomen and pelvis (axial view) showing a 14.3x8.8 cm hematoma observed in the paraumbilical region (black arrow) containing a 3.4x2.2 cm arterial aneurysm connected to the gastroduodenal artery (red arrow), with surrounding edematous changes. These findings are suggestive of a large, thrombosed GDA aneurysm.
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case_images: Subsequently, an abdominal CT angiography (Figure 1) was performed, which revealed a hematoma measuring approximately 14.3x8.8 cm in the paraumbilical region.
case_images: Intraoperative view showing the evacuation of a large intra-abdominal hematoma collection located between the duodenum and the gastroduodenal artery aneurysm.
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case_images: The flexure of the liver and the transverse colon were mobilized inferiorly from the head of the pancreas and clotted blood was removed from the lesser momentum (Figure 2).
case_images: Intraoperative view showing mobilization of the pylorus and duodenum away from the head of the pancreas, exposing a fistula that connected the duodenum and the aneurysm.
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case_images: Mobilization of the pylorus and duodenum away from the head of the pancreas exposed a fistula that connected the duodenum and the aneurysm, without digestive content (Figure 3).
case_images: Postoperative photo shows no complications at the site of incision.
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case_images: The patient's recovery progressed without complications (Figure 4).