Clin Endosc.  2025 Jan;58(1):158-160. 10.5946/ce.2024.138.

An enigmatic enteroscopic image in a patient with upper gastrointestinal bleeding

• Pessarelli T
• Marinoni B
• Ierardi AM
• Tontini GE

• KMID: 2564032
• DOI: http://doi.org/10.5946/ce.2024.138

Figure

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  Fig. 1. Two enteroscopic images of an enigmatic amorphous tissue of uncertain origin, with underlying oozing bleeding, at the site of the hepatico-jejunal anastomosis.

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  Fig. 2. (A) Pre-procedural ultrasonography documenting a voluminous pseudoaneurysm of the hepatic artery propria with the pathognomonic “Yin and Yang sign”, determined by the typical inflow and outflow of blood as a swirling motion in the sac through the neck. (B) Arteriography confirming the presence of a pseudoaneurysm of the hepatic artery, corresponding in shape, size, and location with the structure visualized at anterograde double-balloon enteroscopy. (C) Arteriography with embolization of the gastroduodenal artery. (D) Arteriography with stenting of the hepatic artery and subsequent exclusion of the pseudoaneurysm.

Reference

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