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. 2023 Sep 6;59(9):1606. doi: 10.3390/medicina59091606

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© 2023 by the authors.

Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).

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A young woman with a history of non-steroidal anti-inflammatory drug (NSAID) overuse experienced a sudden onset of hematemesis. During endoscopy, duodenal bleeding was observed but proved unresponsive to treatment. Advanced imaging techniques, including axial Computed Tomography scans (A) and multiplanar reconstruction (MPR) coronal reconstruction (B), revealed the presence of a pseudoaneurysm in the gastroduodenal artery. The celiac trunk was subsequently catheterized, confirming the presence of the pseudoaneurysm (arrow) close to the clip previously placed by the endoscopist at the site of bleeding (C). To address the condition, a superselective catheterization of the gastroduodenal artery was performed using a dimethyl sulfoxide (DMSO)-compatible microcatheter, followed by effective embolization using Ethylene-Vinyl Alcohol (EVOH) copolymer (D). The completion angiography confirmed the successful embolization, with the EVOH copolymer cast distributed along the gastroduodenal artery, ensuring no unintended embolizations to non-target areas (E).