Successful endovascular treatment of duodenal obstruction caused by large abdominal aortic aneurysm.

James Newman, Joanne L Calley, Chung S Lim, Yaser Naji, Saroj Das

Journal: Annals of vascular surgery 2016;29(6):1322.e1-4

PMID: 26146235

Full Text on Elsevier Science View on PubMed

Abstract

BACKGROUND

Abdominal aortic aneurysm (AAA) causing duodenal obstruction is not a common presentation. Our literature review demonstrated that open surgery was often used to treat such problem. Here, we describe the first case of an endovascular approach to treat acute duodenal obstruction caused by a massive infrarenal AAA.

CASE REPORT

An 84-year-old man presented with acute abdominal pain and distension, vomiting, decreasing appetite, and weight loss. Computed tomography scan confirmed a large infrarenal AAA causing duodenal obstruction. The patient was started on total parenteral nutrition, and the aneurysm treated by endovascular aneurysm repair (EVAR). Postoperatively, the patient's symptoms of duodenal obstruction gradually resolved.

CONCLUSIONS

EVAR is a viable treatment option for patients presenting with duodenal obstruction caused by AAA.

Address: Department of Vascular Surgery, North West London Hospitals NHS Trust, Middlesex, UK.; Department of Radiology, North West London Hospitals NHS Trust, Middlesex, UK.; Department of Vascular Surgery, North West London Hospitals NHS Trust, Middlesex, UK. Electronic address: [email protected].

DOI: 10.1016/j.avsg.2015.03.050

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MeSH Terms: Aged, 80 and over, Aortic Aneurysm, Abdominal, Aortography, Blood Vessel Prosthesis, Blood Vessel Prosthesis Implantation, Duodenal Obstruction, Endovascular Procedures, Humans, Male, Parenteral Nutrition, Total, Stents, Tomography, X-Ray Computed, Treatment Outcome