Pancreaticoduodenal artery aneurysm presenting with retroperitoneal haemorrhage and gastric outlet obstruction: a case report

Pancreaticoduodenal artery (PDA) aneurysms are rare visceral vascular lesions, accounting for less than 2% of all visceral artery aneurysms. They are frequently associated with celiac artery stenosis, which promotes high-flow collateralization through the pancreaticoduodenal arcade. We present the case of a 73-year-old man who presented with acute abdominal pain and syncope. Initial imaging revealed a large retroperitoneal hematoma without active contrast extravasation. The patient subsequently developed gastric outlet obstruction due to extrinsic compression by the hematoma. Repeat CT angiography identified a PDA aneurysm associated with severe celiac trunk stenosis. The patient was successfully treated with transcatheter coil embolization. This case highlights the diagnostic challenges of PDA aneurysms and the importance of evaluating the celiac axis in patients with retroperitoneal hemorrhage.