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CC BY-NC-ND 4.0 · Journal of Gastrointestinal and Abdominal Radiology 2018; 01(01): 072-074
DOI: 10.1055/s-0038-1676155
Case Report
Indian Society of Gastrointestinal and Abdominal Radiology

An Odd Case of Melena: Chronic Celiac Artery Dissection and Hepatic Arterioduodenal Fistula

Lijesh Kumar
1   Department of Interventional Radiology, PVS Institute of Digestive Diseases, PVS Memorial Hospital, Cochin, Kerala, India
,
Cyriac Abby Philips‡
2   Department of Hepatology and Liver Transplant Medicine, PVS Institute of Digestive Diseases, PVS Memorial Hospital, Cochin, Kerala, India
,
Philip Augustine‡
3   Department of Gastroenterology, PVS Institute of Digestive Diseases, PVS Memorial Hospital, Cochin, Kerala, India
› Author Affiliations Funding None.
Further Information

Publication History

Received: 08 September 2018

Accepted after revision: 05 October 2018

Publication Date:
18 June 2019 (online)

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Abstract

We present the case of a 54-year-old chronic alcoholic man who presented to the emergency department with intermittent melena for 3 days. Imaging revealed a large dissecting pseudoaneurysm of the common hepatic artery with an arterioduodenal fistula in the second part of the duodenum. The pseudoaneurysm and fistula were managed with refined interventional techniques, and supply to the hepatic arteries was salvaged. In cases of melena that are difficult to diagnose through traditional means, early imaging and interventional management can prove beneficial and improve short-term survival.

Keywords

dissecting aneurysm - computed tomography - melena - hepatoduodenal fistula - pseudoaneurysm - common hepatic artery
 

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