Woman 56 yo with epigastric pain and anemia, RBC= 2.99m/L Hct= 28%
Normal colonoscopy.
US of abdomen detected one retroperitoneum mass near the head of pancreas, looked like hematoma ( US 1, US 2 ,US 3).
MSCT with CE confirmed this mass is retroperitoneum hematoma, maybe..ruptured from small aneurism of gastroduodenal artery (CT1, CT 2, CT 3 CT 4 3D reconstruction).
Emergency DSA detected the abnormal.variation of hepatic artery..and small aneurysm of gastroduodenal artery..had stopped bleeding.
Survey this case for Hct dropped to 25% and operation detected this small ruptured aneurysma..which was in ligation for control.bleeding.
Post-op is well recovery .
Conclusion: Ruptured retroperitoneum aneurysm is easily diagnosed by ultrasound , CT and, DSA.