{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T21:51:20Z","timestamp":1777672280616,"version":"3.51.4"},"reference-count":31,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,3,22]],"date-time":"2025-03-22T00:00:00Z","timestamp":1742601600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,3,22]],"date-time":"2025-03-22T00:00:00Z","timestamp":1742601600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Investigative Medicine High Impact Case Reports"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:p>Gastroduodenal artery (GDA) pseudoaneurysm is a rare complication of gastric and pancreatic surgery. The presentation is often severe gastrointestinal (GI) bleeding with up to a 90% mortality rate. Proper identification of past gastrectomy based on history or endoscopic appearance is essential for timely embolization or surgery, given that endoscopic management often fails. Here, we present a 65-year-old man who has a history of gastric ulcer-related surgery without clear documentation and hypertension presented with hematemesis, black stools, and syncope. Upper endoscopy showed signs of gastroenterostomy with stenosis and duodenal ulcer with spurting hemorrhage. Two days after endoscopic therapy, a recurrence of massive GI bleeding was noted. A celiac arteriogram was done by interventional radiology, demonstrating a pseudoaneurysm off the GDA. Successful embolization was performed with helical coils. The GI bleeding stopped, and the patient became stable after that. The GDA pseudoaneurysm-related bleeding should always be suspected in patients who underwent gastrectomy, bypass surgery, or pancreatectomy. Endoscopic interventions are usually temporary and sometimes can only give anatomical correlation before angiogram and embolization offer a definite treatment. Patients with GDA pseudoaneurysm can be entirely asymptomatic for a long time. The most common site of bleeding is the duodenum. Surgical interventions can also be offered if an angiogram is not successful in stopping the bleeding.<\/jats:p>","DOI":"10.1177\/23247096251323076","type":"journal-article","created":{"date-parts":[[2025,3,22]],"date-time":"2025-03-22T05:42:08Z","timestamp":1742622128000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Gastroduodenal Artery (GDA) Pseudoaneurysm as a Cause of Massive Upper Gastrointestinal (GI) Bleeding Years After Partial Gastrectomy"],"prefix":"10.1177","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9549-8352","authenticated-orcid":false,"given":"Hussam","family":"Almasri","sequence":"first","affiliation":[{"name":"University of North Dakota, Fargo, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sana","family":"Rabeeah","sequence":"additional","affiliation":[{"name":"University of Toledo Medical Center, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guneet","family":"Sidhu","sequence":"additional","affiliation":[{"name":"University of North Dakota, Fargo, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arman","family":"Qurashi","sequence":"additional","affiliation":[{"name":"University of North Dakota, Fargo, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Bassett","sequence":"additional","affiliation":[{"name":"Sanford Health, Fargo, ND, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bisher","family":"Sawaf","sequence":"additional","affiliation":[{"name":"University of Toledo Medical Center, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shahem","family":"Abbarh","sequence":"additional","affiliation":[{"name":"MedStar Health, Baltimore, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,3,22]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"crossref","first-page":"11","DOI":"10.3390\/reports2010011","article-title":"Pseudoaneurysm of the inferior pancreaticoduodenal artery due to cholecystitis","volume":"2","author":"George J","year":"2019","unstructured":"George J, Besant S, Cleveland T, et al Pseudoaneurysm of the inferior pancreaticoduodenal artery due to cholecystitis. Reports. 2019;2:11.","journal-title":"Reports"},{"key":"e_1_3_2_3_2","article-title":"Ruptured ileocolic artery pseudoaneurysm: case report","volume":"20","author":"Sant\u2019Anna CV","year":"2021","unstructured":"Sant\u2019Anna CV, Kuhl FG, Leite AM, et al Ruptured ileocolic artery pseudoaneurysm: case report. J Vasc Bras. 2021;20:e20210163.","journal-title":"J Vasc Bras"},{"key":"e_1_3_2_4_2","doi-asserted-by":"crossref","first-page":"104","DOI":"10.31486\/toj.19.0110","article-title":"Gastroduodenal artery pseudoaneurysm causing obstructive jaundice","volume":"21","author":"Chapman BM","year":"2021","unstructured":"Chapman BM, Bolton JS, Gioe SM, et al Gastroduodenal artery pseudoaneurysm causing obstructive jaundice. Ochsner J. 2021;21:104-107.","journal-title":"Ochsner J"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.3348\/kjr.2016.17.3.351"},{"issue":"5","key":"e_1_3_2_6_2","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1016\/j.circir.2015.06.006","article-title":"Seudoaneurismas pancre\u00e1ticos: formas de presentaci\u00f3n y opciones terap\u00e9uticas","volume":"83","author":"V\u00e1zquez-Ruiz J","year":"2015","unstructured":"V\u00e1zquez-Ruiz J, L\u00f3pez-Flor V, Aguado-P\u00e9rez M, et al Seudoaneurismas pancre\u00e1ticos: formas de presentaci\u00f3n y opciones terap\u00e9uticas. Cirug\u00eda Y Cirujanos. 2015;83(5):454-455.","journal-title":"Cirug\u00eda Y Cirujanos"},{"key":"e_1_3_2_7_2","doi-asserted-by":"crossref","first-page":"1198378","DOI":"10.3389\/fmed.2023.1198378","article-title":"Case report: duodenal obstruction caused by gastroduodenal artery pseudoaneurysm with hematoma: an unusual case and literature review","volume":"10","author":"Zhou YY","year":"2023","unstructured":"Zhou YY, Wang SC, Seak CJ, Huang SW, Cheng HT. Case report: duodenal obstruction caused by gastroduodenal artery pseudoaneurysm with hematoma: an unusual case and literature review. 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ACG Case Rep J. 2020;7:e00347.","journal-title":"ACG Case Rep J"},{"key":"e_1_3_2_11_2","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1186\/s40792-020-00802-3","article-title":"Gastroduodenal artery pseudoaneurysm hemorrhage 1 year after laparoscopic distal gastrectomy: a case report","volume":"6","author":"Kunitomo A","year":"2020","unstructured":"Kunitomo A, Misawa K, Sato Y, et al Gastroduodenal artery pseudoaneurysm hemorrhage 1 year after laparoscopic distal gastrectomy: a case report. Surg Case Rep. 2020;6:38.","journal-title":"Surg Case Rep"},{"issue":"4","key":"e_1_3_2_12_2","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1159\/000511463","article-title":"An astounding percutaneous endoscopic gastrostomy complication: a pseudoaneurysm of gastroduodenal artery","volume":"28","author":"Jo\u00e3o M","year":"2021","unstructured":"Jo\u00e3o M, Alves S, Carvalheiro V, Areia M. 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Jop. 2004;5:328-337.","journal-title":"Jop"},{"issue":"3","key":"e_1_3_2_30_2","first-page":"150","article-title":"[Gastroenterostomy, indications\u2013complications\u2013reparation (author\u2019s transl)]","volume":"102","author":"Eichen R","year":"1977","unstructured":"Eichen R, Eichfuss HP, D\u00f6rner A, Koch G. [Gastroenterostomy, indications\u2013complications\u2013reparation (author\u2019s transl)]. Zentralbl Chir. 1977;102(3):150-155.","journal-title":"Zentralbl Chir"},{"issue":"3","key":"e_1_3_2_31_2","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.1053\/j.gastro.2020.05.095","article-title":"AGA clinical practice update on endoscopic therapies for non-variceal upper gastrointestinal bleeding: expert review","volume":"159","author":"Mullady DK","year":"2020","unstructured":"Mullady DK, Wang AY, Waschke KA. AGA clinical practice update on endoscopic therapies for non-variceal upper gastrointestinal bleeding: expert review. 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