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The gastroduodenal artery can be the source of a significant gastrointestinal bleed, which may arise as a complication of peptic ulcer disease.Because of its close relationship to the posteromedial wall of the second part of the duodenum, deeply penetrating ulcers or tumours of the duodenum may cause torrential bleeding from the gastroduodenal ‘artery of haemorrhage'. [1]
The duodenal bulb is the site of duodenal ulcer occurrence. Duodenal ulcers are more common than gastric ulcers and - unlike gastric ulcers - are caused by increased gastric acid secretion. Duodenal ulcers are commonly located anteriorly, and rarely posteriorly. Anterior ulcers can be complicated by perforation, while the posterior ones bleed.
A perforated ulcer is a condition in which an untreated ulcer has burned through the mucosal wall in a segment of the gastrointestinal tract (e.g., the stomach or colon) allowing gastric contents to leak into the abdominal cavity.
Posterior gastric wall perforation may lead to bleeding due to the involvement of gastroduodenal artery that lies posterior to the first part of the duodenum. [23] The death rate in this case is 20%. [ 16 ]
A peptic ulcer is a defect in the inner lining of the stomach or duodenum typically due to excessive stomach acid. Extension of the ulcer through the lining of the digestive tract results in spillage of the stomach or intestinal contents into the abdominal cavity, leading to an acute chemical peritonitis. [13] [14] Helicobacter pylori infection ...
Duodenal causes: Duodenal ulcer; Vascular malformation, including aorto-enteric fistulae. Fistulae are usually secondary to prior vascular surgery and usually occur at the proximal anastomosis at the third or fourth portion of the duodenum where it is retroperitoneal and near the aorta. [5] [6] [7] Hematobilia, or bleeding from the biliary tree
The retroduodenal arteries are several [1] [2] small [2] arteries which usually [1] arise from the gastroduodenal artery [1] [2] posterior to the superior part of duodenum, but may also arise from the posterior superior pancreaticoduodenal artery.
Endoscopy image of a duodenal ulcer in the posterior part of the duodenal bulb without stigmata of recent hemorrhage. This would be a Forrest III lesion. Acute hemorrhage. Forrest I a (Spurting hemorrhage) Forrest I b (Oozing hemorrhage) Signs of recent hemorrhage. Forrest II a (Non bleeding Visible vessel)