Hepatic Portal Venous Gas with Gastric Emphysema after Transcatheter Arterial Embolization for Ruptured Anterior Superior Pancreaticoduodenal Artery Aneurysm

A 54-year-old man presented with epigastric pain and underwent contrast-enhanced computed tomography. A ruptured anterior superior pancreaticoduodenal artery aneurysm was diagnosed. Transcatheter arterial embolization was successfully accomplished using coils; however, the patient started vomiting 18 days later. Contrast-enhanced computed tomography showed hepatic portal venous gas with gastric emphysema and duodenal stenosis. The patient was conservatively treated after being diagnosed with duodenal stenosis caused by hematoma, causing hepatic portal venous gas with gastric emphysema because of increased gastric pressure during vomiting. Consequently, the patient was doing well and was discharged.