Surgical treatment of a huge gastroduodenal artery aneurysm with SMA occlusion: A Case Report

Aim: To present a rare case of a huge gastroduodenal artery aneurysm with superior mesenteric artery occlusion treated by open surgical means.Case: A 62-year-old male patient presented with an abdominal mass and pain associated with new-onset vomiting. A computed tomography angiography revealed a fusiform gastroduodenal aneurysm with a maximum dimension of 11.9 cm, partial thrombosis and calcification, and associated orificial occlusion of the superior mesenteric artery (SMA). After multidisciplinary team discussion and patient consent, surgery was decided. An open midline incision was performed after the diagnosis was confirmed with intraoperative angiography. The aneurysm was opened, and the gastroduodenal artery was ligated. The SMA ostial occlusion was not repaired because of the absence of preoperative symptoms, signs of mesenteric ischemia, and rich collateral circulation. The patient was discharged 48 hours later.Conclusion: Gastroduodenal artery aneurysms are rare pathologies with a high risk of rupture that require individualised therapeutic approaches to achieve optimal outcomes.