Figure 28.

Hematochezia and abdominal pain with pulsatile mass. Fresh blood on colonoscopy without bleeding cause. Upper endoscopy (a) shows active pulsatile bleeding at the third duodenal portion. Axial CTA artery phase (b) and coronal MIP artery phase reconstruction (c) show a large outpouching from the right anterolateral wall of the abdominal aorta at the level of the third duodenal portion with loss of interface fat plane ((b,c) long arrows), The outpouching contains mural thrombosis. No air bubble is depicted in the aortic lumen or wall. No contrast extravasation into the duodenum is seen.