• Jiayu Ju, Ziyao Cheng, Qingliang Zhu, Mingming Deng, and Hailong Zhang.
• Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province, China.
• Medicine (Baltimore). 2023 Feb 3; 102 (5): e32819e32819.

RationaleOwing to the anatomical characteristics of the duodenum, gastroduodenal artery (GDA) pseudoaneurysms can be caused by duodenal ulcers, which may rupture and lead to massive or repeated bleeding. Pseudoaneurysms are usually diagnosed using enhanced computerized tomography or angiography, whereas endoscopic signs have rarely been reported.Patient ConcernsThree patients aged 18 to 83 years with bleeding duodenal ulcers and GDA pseudoaneurysms were treated.DiagnosisAll patients had symptoms of gastrointestinal bleeding, and endoscopy revealed duodenal ulcers with visible vessels or adherent clot pulsations. Angiography confirmed the presence of a GDA pseudoaneurysm, which had an adjacent relationship with the duodenum.InterventionsThe GDA pseudoaneurysm was embolized in each patient.OutcomesThrough transcatheter arterial embolization, endoscopic treatment, and traditional treatment, hematemesis or melena was gradually stopped and all patients were discharged.LessonsThe pulsation of visible vessels or adherent clots observed during endoscopy in patients with duodenal ulcer may indicate the formation of a gastroduodenal artery pseudoaneurysm. Therefore, we suggest that such patients receive enhanced computerized tomography or angiography to assess whether they need timely endovascular intervention treatment to avoid bleeding caused by a pseudoaneurysm.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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