1Department of Pathology, Faculty of Medicine, University of Malaysia, KualaLumpur 59100, Malaysia
2Department of Surgery, Faculty of Medicine, University of Malaysia, KualaLumpur 59100, Malaysia
*Correspondence: Dr. O.P. Murty, Associate Professor and Head Forensic Pathology Unit, Department Pathology, Faculty of Medicine, University Malaysia, Kuala Lumpur 59100, Malaysia. Phone-603 79502912, Fax: +603 79556845. E-mail: dropmurthy2006@hotmail.com, dropmuny@yahoo.co.in
In cases of natural deaths, atherosclerosis and its complications are leading cause of death. One of the complication is aneurysm which is an abnormal dilation due to some weakness or defect in the arterial wall.
In this case a large size measuring 78x7.6 cm aneurysm of inferior patpeatoduodenal branch of superior mesenteric Artery eroded into initial second part of duodenum and led to acute bleeding. There were multiple necrotic areas in the wall of aneurysm. Aneurysm had typical egg's hard shell appearance. One of the area cracked and infiltrated into duodenum. It was also adherent to other structures. It was like a cricket ball size, and was diagnosed earlier by CT scan and was planned for surgery but patient declined to undergo surgery due to age, cosmetic and financial factors. One afternoon she started pain in epigastric region and developed haemetemesis in the hospital. She collapsed within few minutes after vomiting out lot of blood on bed. Death due to aortic aneurysm at bifurcation of abdominal aorta are quite rare and aneurysm of pancreatoduodenal artery are still rarest. Stomach had aboiit 900 gram blood clot, while aneurysm site had about 110 gram blood clot in it. This case report is unique from many points such as bigger size of 78x76 mm bigger in comparison reported, erosion into duodenum, uncommon type of aneurysm, and associated with duodenal ulcers over ruptured site.
Aneurysm, aneurysm rupture, duodenal ulcer complications, superior mesenteric artery, pancreatoduodenal artery
