PMC9980874_01
Computed tomography angiogram (CTA) chest and CTA abdomen and pelvis of the patient.. The images show (A) CTA chest showing an unruptured 1.7 x 0.7 x 1.3 cm saccular aneurysm of the posterior wall of the ascending aorta (red arrow) and (B) CTA abdomen and pelvis showing diffuse aneurysmal dilation (green arrow) of infrarenal abdominal aorta measuring 4.4 x 4.3 cm with no leak or rupture along with a short segment of aortic dissection flap involving 4 cm long segment of aorta.
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FIG1
Computed tomography angiogram (CTA) chest showed an unruptured 1.7 x 0.7 x 1.3 cm saccular aneurysm of the posterior wall of the ascending wall (Figure 1A). CTA abdomen and pelvis showed AAA (4.3 x 4.3 cm) with no leakage or rupture and no active bleeding detected (Figure 1B).
Esophagogastroduodenoscopy (EGD) showing clotted blood in the fundus, first and second parts of the duodenum (green arrows).
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FIG2
Emergent EGD showed gastritis and clotted blood in the fundus as well as in the first and second parts of the duodenum (Figure 2).
Tagged RBC scan showing massive blood (red arrows) throughout the stomach and proximal small bowel (red arrows).
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FIG3
To localize the bleeding source, a tagged RBC scan was performed and showed active bleeding in the stomach and small bowel (Figure 3).