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Messina F, Azzena G, Anania G, Galeotti R, Pelligrini D, Cavallesco G, de Tullio D, Biaino L, Occhionorelli S. Pancreaticoduodenal Artery Aneurysm Ruptured into Duodenum, Associated with Celiac Trunk Stenosis. Case Report and Review of Literature. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/j.ejvsextra.2006.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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52
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Bageacu S, Cuilleron M, Kaczmarek D, Porcheron J. True aneurysms of the pancreaticoduodenal artery: successful non-operative management. Surgery 2006; 139:608-16. [PMID: 16701092 DOI: 10.1016/j.surg.2005.10.015] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2005] [Revised: 10/29/2005] [Accepted: 10/29/2005] [Indexed: 11/30/2022]
Abstract
BACKGROUND True aneurysms of the pancreaticoduodenal arteries (PDA) are rare, often ruptured, and treated by operation with a high level of mortality. We review our experience since 1994 and that of the literature in the past 20 years to provide management guidelines for this uncommon clinical entity. About 100 cases of PDA aneurysms are described in the literature, most of them as case report. METHODS Nine patients were admitted to our institution between 1994 and 2004 for true aneurysm of the PDA. They were analyzed with regard to the clinical presentation, radiologic findings, management, and outcome. RESULTS Seven patients presented for sudden abdominal pain from retroperitoneal hemorrhage. In 2 patients PDA aneurysm was an incidental finding. Abdominal ultrasonography, computed tomographic scan, and visceral angiography was carried out in all cases. Aneurysms ranged from 4 to 30 mm (median, 16.5) in size. Celiac axis stenosis or occlusion was identified in 3 patients. One patient required emergent laparotomy for intra-abdominal rupture of a retro peritoneal hematoma. Therapeutic embolization was successful in all 9 patients. All except 1 are alive with no evidence of recurrence of the true PDA aneurysm with a mean follow-up of 59 months. CONCLUSIONS The authors recommend definitive treatment of all true aneurysms PDA because of their high risk of rupture. Ruptured PDA aneurysms suspected on CT-scan requires emergent visceral angiography and selective embolization as definitive treatment.
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Affiliation(s)
- Serban Bageacu
- University Hospital Saint-Etienne, Saint-Etienne, France.
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53
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Battula N, Malireddy K, Madanur M, Srinivasan P, Karani J, Rela M. True giant aneurysm of gastroduodenal artery. Int J Surg 2006; 6:459-61. [PMID: 19059144 DOI: 10.1016/j.ijsu.2006.05.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2006] [Revised: 05/08/2006] [Accepted: 05/10/2006] [Indexed: 11/19/2022]
Affiliation(s)
- Narendra Battula
- Institute of Liver Studies, Kings College Hospital, Denmark Hill, London SE5 9RS, UK
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54
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El Alaoui M, Olivié D, Gandon Y, Bretagne JF. [Spontaneous peri-pancreatic hematoma associated with celiac trunk stenosis: diagnostic difficulties and therapeutic management]. ACTA ACUST UNITED AC 2006; 29:1169-71. [PMID: 16505765 DOI: 10.1016/s0399-8320(05)82184-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We report a case of spontaneous peri-pancreatic hematoma which was associated with a celiac trunk stenosis. Hematoma was probably due to the rupture of a pancreaticoduodenal artery aneurysm. This diagnosis of pancreatic carcinoma, initially retained, illustrates the difficult diagnostic process. Therapeutic modalities for preventing recurrence are discussed.
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Affiliation(s)
- Mounia El Alaoui
- Service des Maladies de l'Appareil Digestif, Hôpital Pontchaillou, Rennes
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55
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Bellosta R, Luzzani L, Carugati C, Melloni C, Sarcina A. Pancreaticoduodenal Artery Aneurysms Associated with Celiac Axis Occlusion. Ann Vasc Surg 2005; 19:534-9. [PMID: 15981115 DOI: 10.1007/s10016-005-5042-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
True aneurysms of the pancreaticoduodenal artery associated with celiac axis occlusion are very rare; only 38 cases have been reported, according to our literature review. We present three consecutive cases with different options of surgical treatment.
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56
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Weber CH, Pfeifer KJ, Tato F, Reiser M, Rieger J. Transcatheter Coil Embolization of an Aneurysm of the Pancreatico-duodenal Artery with Occluded Celiac Trunk. Cardiovasc Intervent Radiol 2005; 28:259-61. [PMID: 15719185 DOI: 10.1007/s00270-004-0116-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
We report on a case of a wide-necked aneurysm of the pancreatico-duodenal artery with occlusion of the celiac trunk in an asymptomatic patient. The aneurysm was considered to be at high risk of rupture. Successful embolization after interdisciplinary consultation was followed with color-coded duplex ultrasound (CCDS) demonstrating significant flow reduction. Three weeks later CCDS and angiography demonstrated exclusion of the aneurysm and a patent arterial supply of the liver and spleen fed by superior mesenteric artery (SMA) collaterals. The patient has done well so far, without major adverse clinical events or evidence for tissue necrosis of the liver, pancreas or spleen. Discussion of the case and review of the literature indicate that transcatheter embolization is the therapy of choice even in complicated cases.
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Affiliation(s)
- C H Weber
- Institute of Clinical Radiology, LMU Munich, Pettenkoferstrasse 8a, 80336 Munich, Germany.
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57
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Jibiki M, Inoue Y, Iwai T, Sugano N, Igari T, Koike M. Treatment of Three Pancreaticoduodenal Artery Aneurysms Associated with CœLiac Artery Occlusion and Splenic Artery Aneurysm: A Case Report and Review of the Literature. Eur J Vasc Endovasc Surg 2005; 29:213-7. [PMID: 15649732 DOI: 10.1016/j.ejvs.2004.09.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2004] [Indexed: 11/24/2022]
Abstract
A case of three pancreaticoduodenal artery (PDA) aneurysms associated with coeliac artery occlusion and a concomitant splenic arterial aneurysm is described. Surgical treatment was used because it was anticipated that the hepatic blood supply would be obstructed completely if percutaneous transluminal embolization for three PDA aneurysms were performed. Splenectomy in continuity with the splenic artery aneurysm and PDA aneurysmectomies were performed, and infrarenal abdominal aorto-splenic artery bypass was accomplished using a 6mm ringed expanded polytetrafluoroethylene graft. The postoperative course was uneventful. Graft patency and successful aneurysm ablation were confirmed using MRA and intravenous DSA. Arterial histology revealed segmental arterial mediolysis. At 2-year follow-up, the patient was well and asymptomatic. A literature review of PDA aneurysms is presented.
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Affiliation(s)
- M Jibiki
- Department of Vascular and Applied Surgery, Tokyo Medical and Dental University Graduate School, Tokyo, Japan.
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58
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Calkins CM, Moore EE, Turner J, Cothren C, Burch JM. Combined modality treatment of ruptured pancreaticoduodenal artery aneurysms due to celiac artery compression. Surgery 2004; 136:1088-9. [PMID: 15523406 DOI: 10.1016/j.surg.2003.11.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Casey M Calkins
- Department of Surgery, Mercy Childrens Hospital, Kansas City, MO, USA
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59
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Moore E, Matthews MR, Minion DJ, Quick R, Schwarcz TH, Loh FK, Endean ED. Surgical management of peripancreatic arterial aneurysms. J Vasc Surg 2004; 40:247-53. [PMID: 15297817 DOI: 10.1016/j.jvs.2004.03.045] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Peripancreatic artery aneurysms--gastroduodenal (GDA) and pancreaticoduodenal (PDA)--are highly unusual. We report 4 such aneurysms and have collated reports of true peripancreatic artery aneurysms based on an extensive review of the English literature. From this review, patient characteristics, clinical behavior, outcome and management strategies are assessed.
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Affiliation(s)
- Erin Moore
- Department of Surgery, Section of Vascular Surgery, University of Kentucky College of Medicine, Lexington, USA
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60
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Ducasse E, Roy F, Chevalier J, Massouille D, Smith M, Speziale F, Fiorani P, Puppinck P. Aneurysm of the pancreaticoduodenal arteries with a celiac trunk lesion: current management. J Vasc Surg 2004; 39:906-11. [PMID: 15071464 DOI: 10.1016/j.jvs.2003.09.049] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE We report a ruptured aneurysm of the pancreaticoduodenal arteries without acute or chronic pancreatitis but associated with a median arcuate ligament division that compressed the celiac trunk, an exceptional event, thus far described in only 11 patients. We also conducted a targeted review to seek information about clinical presentation, to hasten diagnosis and assist in therapeutic management. METHODS A 54-year-old man with retroperitoneal hemorrhage associated with an arcuate ligament division, documented on computed tomographic scans, underwent diagnostic arteriography and embolization to treat the bleeding aneurysm. In a second elective operation the causative arcuate ligament was sectioned to decompress the celiac artery, to prevent aneurysm recurrence. RESULTS Embolization stopped the aneurysmal bleeding, and arteriograms showed that surgical sectioning resolved the celiac trunk stenosis. At 1-year follow-up the patient had no signs of complications or recurrence of disease. CONCLUSION Ruptured aneurysm of the pancreaticoduodenal arteries associated with stenosis of the celiac trunk is a surgical emergency. Although a literature review disclosed no significant difference between outcomes after open surgery and radiologic arterial embolization, our experience in this case suggests immediate embolization during arteriography as the most effective treatment. Later, to prevent recurrence, the arcuate ligament should be surgically sectioned and the celiac artery stenosis treated.
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Affiliation(s)
- E Ducasse
- Unit of Vascular Surgery, Catholic Institute of Lille, France.
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61
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Arao T, Ishida E, Nishina S, Yamane H, Adachi M, Sunayama T, Suzuki S, Katoh T. Catastrophic intraabdominal bleeding due to rupture of pancreaticoduodenal artery aneurysm: successful transcatheter arterial embolization. Pancreas 2003; 26:99-100. [PMID: 12499927 DOI: 10.1097/00006676-200301000-00019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Tokuzo Arao
- Department of Internal Medicine, Sumitomo Besshi Hospital, Ehime, Japan
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62
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Hossain A, Reis ED, Dave SP, Kerstein MD, Hollier LH. Visceral Artery Aneurysms: Experience in a Tertiary-Care Center. Am Surg 2001. [DOI: 10.1177/000313480106700510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Visceral artery aneurysms (VAAs) often rupture and cause serious morbidity or death. The purpose of this study was to identify conditions associated with VAA in a series of 30 patients treated at our institution from 1988 through 1998. Demographics, types of aneurysms, associated conditions, diagnoses, treatments, and outcomes were recorded and analyzed. Thirty patients (16 men and 14 women) with VAA were identified. The arteries involved were splenic (eight), renal (ten), hepatic (nine), hypogastric (one), celiac (one), and pancreaticoduodenal (one). Five of eight (63%) splenic artery aneurysms occurred in women; however, gender was not a factor in other aneurysmal groups. Splenic artery aneurysm also was associated with cirrhosis in four of the eight (50%) patients. Five of the nine (56%) hepatic artery aneurysms were associated with cirrhosis; two of these were pseudoaneurysms that occurred after liver transplantation. Five of ten (50%) renal artery aneurysms were associated with juxtarenal abdominal aortic aneurysms. Celiac and pancreaticoduodenal aneurysms were associated with gastrointestinal bleeding. Treatments included surgery (19), embolization (eight), and observation alone (three). These data demonstrate that association with other conditions varies according to subgroups of VAA. Despite advances in diagnosis and therapy the heterogeneity of VAA suggests that management must remain individualized.
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Affiliation(s)
- Azhar Hossain
- Department of Surgery, The Mount Sinai Medical Center, New York, New York
| | - Ernane D. Reis
- Department of Surgery, The Mount Sinai Medical Center, New York, New York
| | - Sandeep P. Dave
- Department of Surgery, The Mount Sinai Medical Center, New York, New York
| | - Morris D. Kerstein
- Department of Surgery, The Mount Sinai Medical Center, New York, New York
| | - Larry H. Hollier
- Department of Surgery, The Mount Sinai Medical Center, New York, New York
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63
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de Perrot M, Berney T, Deléaval J, Bühler L, Mentha G, Morel P. Management of true aneurysms of the pancreaticoduodenal arteries. Ann Surg 1999; 229:416-20. [PMID: 10077055 PMCID: PMC1191708 DOI: 10.1097/00000658-199903000-00016] [Citation(s) in RCA: 95] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To review the authors' recent experience and that of the literature since 1973 and to provide management guidelines for true aneurysms of the pancreaticoduodenal arteries (PDA). SUMMARY BACKGROUND DATA True aneurysms of the PDA are rare, with a total of only 52 cases reported since 1973. METHODS Six patients were admitted to the authors' institution between 1985 and 1995 for rupture of a true aneurysm of the PDA. They were analyzed with regard to the mode of presentation, preoperative workup, management, and outcome. RESULTS All patients had severe epigastric pain from retroperitoneal hemorrhage. Computed tomography scanning and angiography were performed in all cases. Aneurysms ranged from 0.7 to 1.2 cm (median 0.9 cm). The celiac axis was stenotic or occluded in five cases. Three patients underwent emergency pancreatoduodenectomy. Two of them survived. In one case, section of the median arcuate ligament was associated with the procedure, and the patient died from an aortic dissection. Embolization was performed in the last three patients. The procedure was definitive in two cases. In one, hemorrhage recurred 8 days later and required surgical ligation of the bleeding artery. CONCLUSIONS The authors recommend rapid treatment of all true aneurysms of the PDA. Because most of these aneurysms result from a stenosis of the celiac axis, selective embolization may help to preserve patency of the PDA and should, therefore, be the primary therapeutic choice in ruptured aneurysms. Close follow-up is mandatory because of possible recurrent bleeding. Appropriate and expeditious management of true PDA aneurysms should help reduce the mortality rate.
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Affiliation(s)
- M de Perrot
- Clinic of Digestive Surgery, Department of Surgery, University Hospital of Geneva, Switzerland
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64
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Coll DP, Ierardi R, Kerstein MD, Yost S, Wilson A, Matsumoto T. Aneurysms of the pancreaticoduodenal arteries: a change in management. Ann Vasc Surg 1998; 12:286-91. [PMID: 9588518 DOI: 10.1007/s100169900155] [Citation(s) in RCA: 95] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Since the first report of an aneurysm involving the pancreaticoduodenal arteries a century ago, only 83 cases have been reported in our collective review of the English literature. Their presentation varies from indistinct abdominal pain to hemorrhagic shock, often making the diagnosis onerous. The mortality rate in this patient group has been significant, and in cases reported since 1980, the mortality rate remains at 17% (7 deaths/42 reported cases). Surgery has been, and continues to be, the cornerstone of therapy, with an incumbent mortality rate of 19% (5 deaths/26 patients treated surgically since 1980). This case report and 100-year review of the literature describes the causes, natural history, and historic management of pancreaticoduodenal artery aneurysms. Most importantly, it demonstrates the use of angiographic embolization in the definitive management of these aneurysms with no mortality.
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Affiliation(s)
- D P Coll
- Medical College of Pennsylvania/Hahnemann University Hospital/Allegheny University of the Health Sciences, Philadelphia 19102-1192, USA
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65
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Quandalle P, Gambiez L, Brami F, Ghisbain H, André JM, Zahredine A, Saudemont A. [Gastrointestinal hemorrhage caused by rupture of an aneurysm of visceral arteries. Presentation of 4 cases]. CHIRURGIE; MEMOIRES DE L'ACADEMIE DE CHIRURGIE 1998; 123:139-47. [PMID: 9752535 DOI: 10.1016/s0001-4001(98)80098-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
STUDY AIM Gastrointestinal bleeding by rupture of splanchnic artery aneurysms is very rare. The aim of this study is to report four cases observed between 1990 and 1996. MATERIALS AND METHODS In the first case, the celiac trunk aneurysm was revealed by hematemesis due to erosion of the posterior wall of the stomach. Excision of the aneurysm associated with splenopancreatectomy was followed by revascularization of the common hepatic artery with a bypass implanted in the aorta. The second case concerned a splenic artery aneurysm revealed by hemosuccus pancreaticus and intestinal bleeding which was treated by excision and splenopancreatectomy. In the third case, the common hepatic artery aneurysm revealed by hemosuccus pancreaticus and intestinal bleeding was treated by obstructive endoaneurysmorrhaphy. The fourth case concerned a superior mesenteric aneurysm revealed by duodenal erosion causing gastric and intestinal bleeding, which was treated by obstructive endoaneurysmorrhaphy and revascularization of the mesenteric artery by a spleno-mesenteric bypass. RESULTS Surgical treatment was successful in all four patients. In the first case, an acute acalculous cholecystitis required a cholecystectomy after 3 weeks. In the fourth case, a splenic infarction disappeared spontaneously. CONCLUSION Such observations are rare. The site of the bleeding was located by endoscopy. The aneurysm was recognized by contrast-enhanced computerized tomography (CT) scan and/or celiac and mesenteric arteriography which was performed in all cases and was very useful for the management of such aneurysms. After excision (n = 2) or obliterative endoaneurysmorrhaphy (n = 2), revascularization had to be done in two cases for celiac and mesenteric aneurysms.
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Affiliation(s)
- P Quandalle
- Service de chirurgie adultes ouest, hôpital Claude-Huriez, CHRU, Lille, France
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66
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Neschis DG, Safford SD, Golden MA. Management of pancreaticoduodenal artery aneurysms presenting as catastrophic intraabdominal bleeding. Surgery 1998. [DOI: 10.1016/s0039-6060(98)70222-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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67
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Sallou C, Cron J, Julia P, Fabiani JN. Aneurysm of the inferior mesenteric artery: case report and review of the literature. Eur J Vasc Endovasc Surg 1997; 14:71-4. [PMID: 9290564 DOI: 10.1016/s1078-5884(97)80229-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- C Sallou
- Department of Cardiovascular Surgery, Hôpital Broussais, Paris, France
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68
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Shanley CJ, Shah NL, Messina LM. Uncommon splanchnic artery aneurysms: pancreaticoduodenal, gastroduodenal, superior mesenteric, inferior mesenteric, and colic. Ann Vasc Surg 1996; 10:506-15. [PMID: 8905073 DOI: 10.1007/bf02000601] [Citation(s) in RCA: 104] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- C J Shanley
- University of Michigan Medical Center, Ann Arbor, USA
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69
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Paty PS, Cordero JA, Darling RC, Chang BB, Shah DM, Leather RP. Aneurysms of the pancreaticoduodenal artery. J Vasc Surg 1996; 23:710-3. [PMID: 8627910 DOI: 10.1016/s0741-5214(96)80054-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
True aneurysms of the pancreaticoduodenal artery are a rare form of visceral artery aneurysm. Two cases are presented and options for treatment are reviewed.
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Affiliation(s)
- P S Paty
- Albany Medical College, Vascular Surgery Section, NY 12208, USA
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70
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Uher P, Nyman U, Ivancev K, Lindh M. Aneurysms of the pancreaticoduodenal artery associated with occlusion of the celiac artery. ABDOMINAL IMAGING 1995; 20:470-3. [PMID: 7580788 DOI: 10.1007/bf01213275] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Aneurysms of the pancreaticoduodenal artery are rare and may be associated with celiac artery stenosis or occlusion. Twenty-eight patients are reported in the literature. The diagnostic findings and therapeutic alternatives of four additional patients form the basis of this report. One patient with ruptured pancreaticoduodenal aneurysm was successfully treated by transcatheter embolization, and one patient was treated surgically; both patients had an uneventful recovery. In the remaining two patients, the aneurysms were left untreated. One patient died 1 year later of an unrelated cause, and the other patient is symptom-free after 2 years.
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Affiliation(s)
- P Uher
- Department of Diagnostic Radiology, Malmö General Hospital, University of Lund, Sweden
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71
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Gouny P, Fukui S, Aymard A, Decaix B, Mory H, Merland JJ, Nussaume O. Aneurysm of the gastroduodenal artery associated with stenosis of the superior mesenteric artery. Ann Vasc Surg 1994; 8:281-4. [PMID: 8043362 DOI: 10.1007/bf02018176] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
A 68-year-old patient was hospitalized after the incidental discovery of an aneurysm of the gastroduodenal artery associated with stenosis of the superior mesenteric artery. This patient had severe heart failure, which led to acute pulmonary edema and inoperable triple-vessel coronary disease. In the first of two procedures the superior mesenteric artery was dilated; 48 hours later the gastroduodenal artery aneurysm was embolized with minicoils and acryl glue. Immediate and follow-up arteriograms at 10 months showed that results were satisfactory. Transluminal treatment of both lesions is an alternative to surgical treatment, especially in high-risk patients.
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Affiliation(s)
- P Gouny
- Service de Chirurgie Vasculaire et Thoracique, Hôpital Rothschild, Paris, France
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72
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Tsuno N, Sawada T, Shigematsu H, Kubota Y, Watanabe T, Sameshima S, Shinozaki M, Muto T. A case report of celiac axis compression and implications in regional chemotherapy for liver metastasis. GASTROENTEROLOGIA JAPONICA 1993; 28:431-6. [PMID: 8344505 DOI: 10.1007/bf02776990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Regional chemotherapy through a catheter placed in the hepatic artery is routinely used for treatment of unresectable liver metastasis from colon carcinoma. With some frequency, anatomical variations of the hepatic artery, including compression of the celiac axis, are found, and must be recognized preoperatively for appropriate management and placement of the catheter. We report a case of a colon cancer patient with multiple liver metastases and compression of the celiac axis, who received decompression of the celiac axis and catheterization of the hepatic artery.
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Affiliation(s)
- N Tsuno
- First Department of Surgery, University of Tokyo, Faculty of Medicine, Japan
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