PMC7163285_01
Abdominal computed tomography (CT) scan and upper gastrointestinal endoscopy (UGE).. Axial (a) and coronal (b) abdominal CT scan revealed that the abdominal aortic aneurysm (black arrow) below the renal artery was dilated 7.6 x 5.4 cm, which compressed the duodenum (white arrows). (c) UGE revealed a large amount of fresh blood and blood clots in the bulb of the duodenum.
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Abdominal computed tomography (CT) scan revealed that the abdominal aorta below the renal artery was dilated by 7.6 x 5.4 cm (Fig. 1a and b); thus, imminent rupture was suspected. Upper gastrointestinal endoscopy revealed a large amount of fresh blood and blood clots in the bulbs of the duodenum, and bleeding from the duodenum was suspected (Fig. 1c).
Abdominal computed tomography (CT) scan and duodenography.. (a) Postoperative abdominal CT scan revealed that the I-shaped graft had good patency (white arrow). (b) Contrast media passed through the duodenojejunostomy without any problem.
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He was discharged on the 35th postoperative day (Fig. 2a and b).
PMC7163285_02
Upper gastrointestinal endoscopy (UGE) and abdominal computed tomography (CT) scan.. (a) UGE revealed the beating hematoma on the anal side of the major papilla. Axial (b) and sagittal (c) abdominal CT scan revealed the dilated irregularly shaped aneurysm (black arrow) on the proximal side of the prosthetic vascular graft, which compressed the duodenum (white arrows).
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Upper gastrointestinal endoscopy revealed a hematoma which pulsed on the anal side of the duodenal papilla (Fig. 3a). Abdominal CT scan revealed a dilated irregularly shaped aneurysm, which was located proximal to the aortic graft (Fig. 3b and c).
Operative finding.. A 1-cm perforation was found in the third part of the duodenum (white arrow).
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We then incised the third part of the duodenum and closed the 1-cm fistula (Fig. 4).
Abdominal computed tomography (CT) scan.. Postoperative abdominal CT scan showed that endovascular aneurysm repair was performed and the superior mesenteric artery was reconstructed (white arrow).
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The patient underwent dialysis after surgery, and he was weaned from the ventilator on the 7th postoperative day (Fig. 5).