Open resection of gastroduodenal artery aneurysm with fistulization into the duodenum 17 years after coil embolization in a patient with Caroli disease

Gastroduodenal artery aneurysm (GDAA) is a very rare vascular condition with a high risk of fatal rupture. Coil embolization is the recommended treatment for GDAA. This is a unique case of a 57-year-old woman with autosomal recessive polycystic kidney disease requiring renal transplantation, and Caroli disease who presented with hemorrhage related to enteric fistulization of a GDAA 17 years after coil embolization. Unsuccessful endoscopic and endovascular management necessitated open surgical resection and omental patching. The patient had an uneventful recovery and is still alive without recurrence 3 years later.