1
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Ritenour A, Mousa A. Successful endovascular treatment of acute mesenteric and hepatic ischemia in patient with celiomesenteric trunk occlusion. J Vasc Surg Cases Innov Tech 2023; 9:101314. [PMID: 37860725 PMCID: PMC10582744 DOI: 10.1016/j.jvscit.2023.101314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 08/17/2023] [Indexed: 10/21/2023] Open
Abstract
Acute occlusion of celiomesenteric trunk variants such as a replaced common hepatic artery origin from a superior mesenteric artery can be catastrophic and requires immediate attention to reverse simultaneous mesenteric and hepatic ischemia and prevent death. We report the case of a 73-year-old woman with acute occlusion of her celiomesenteric trunk and proximal superior mesenteric artery who underwent successful endovascular repair with stent graft via brachial access. In the present case report, we describe a surgically relevant classification system of celiomesenteric trunk variants, highlight the feasibility of endovascular intervention in this uncommon scenario, and describe our technique.
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Affiliation(s)
- Amber Ritenour
- Vascular Surgery Services, WVU Heart and Vascular Institute, WVU Medicine, Parkersburg, WV
| | - Albeir Mousa
- Vascular Surgery Services, WVU Heart and Vascular Institute, WVU Medicine, Parkersburg, WV
- Division of Vascular Surgery, Department of Cardiovascular and Thoracic Surgery, Thomas Memorial Hospital, WVU Medicine, Charleston, WV
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2
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Lanka SP, Sandhu SJS, Farres H, Erben Y. Repair of Celiomesenteric Trunk Aneurysm and Review of the Literature. Cureus 2023; 15:e35923. [PMID: 37050993 PMCID: PMC10085253 DOI: 10.7759/cureus.35923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2023] [Indexed: 04/14/2023] Open
Abstract
A celiomesenteric trunk (CMT) is a rare anatomic variant of a common origin for the celiac and superior mesenteric arteries. It is further a seldom occurrence to have aneurysmal dilatation of the CMT. Herein, we describe a patient with a CMT aneurysm and his open surgical repair. The open surgical repair included debranching from the right external iliac artery to the splenic and common origin of the superior mesenteric and common hepatic arteries using a bifurcated knitted graft. Postoperative recovery was unremarkable, and follow-up imaging demonstrated an excluded CMT aneurysm with excellent blood flow to the intra-abdominal organs through the bifurcated graft.
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Affiliation(s)
- Santh Prakash Lanka
- Division of Vascular and Endovascular Surgery, Mayo Clinic, Jacksonville, USA
| | | | - Houssam Farres
- Division of Vascular and Endovascular Surgery, Mayo Clinic, Jacksonville, USA
| | - Young Erben
- Division of Vascular and Endovascular Surgery, Mayo Clinic, Jacksonville, USA
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3
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Persistence of Abdominal Pain: Did You Check for Mesenteric Vessels? Medicina (B Aires) 2023; 59:medicina59030442. [PMID: 36984442 PMCID: PMC10059859 DOI: 10.3390/medicina59030442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/21/2023] [Accepted: 02/21/2023] [Indexed: 02/25/2023] Open
Abstract
The incidence of abnormalities regarding the celiac-mesenteric trunk (CMT) has been reported to be between 1% and 2.7%, whereas for visceral aneurysms the incidence is between 0.1% and 0.2% of the general population. Anatomical variations in the CMT may be the result of abnormal embryogenesis of the primitive segmental splanchnic arteries that supply the bowel and several abdominal organs. The clinical presentation may range from vague abdominal symptoms to aneurysm rupture with a significant mortality risk. In this case, we describe the clinical history of a 37-year-old man with postprandial abdominal pain likely related to the celiac-mesenteric trunk enlargement, associated with high resistance flow in the proximal site. Postprandial symptoms improved by avoiding large meals and surveillance for the CMT anomalies was recommended by cross-imaging including the echo-color-Doppler to assess blood flow modification.
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4
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Szczerepa D, Gallagher M, Fluss G, Trocha K, Finlay D. Nutcracker Phenomenon as a Result of Celiomesenteric Trunk Aneurysm. Ann Vasc Surg 2021; 79:441.e1-441.e8. [PMID: 34653637 DOI: 10.1016/j.avsg.2021.07.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 06/24/2021] [Accepted: 07/22/2021] [Indexed: 11/01/2022]
Abstract
A common origin of the celiac trunk and superior mesenteric artery is exceedingly rare, and aneurysms of this common trunk are even rarer. According to our literature search, there are no reported cases of nutcracker syndrome or phenomenon involving this rare aneurysmal anomaly. Repair of such anomalies is standardly via open surgical approach with few reported cases of endovascular repair. We describe a patient with an aneurysm of the celiomesenteric trunk resulting in nutcracker phenomenon of the left renal vein. The celiomesenteric trunk aneurysm was repaired endovascularly, resulting in decreased surrounding inflammation and improvement of the left renal vein compression.
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Affiliation(s)
| | - Margaret Gallagher
- Department of Surgery, New York Medical College at Metropolitan Hospital Center, New York, NY
| | - Gabriella Fluss
- Department of Surgery, New York Medical College at Metropolitan Hospital Center, New York, NY
| | - Kaspar Trocha
- Department of Surgery, New York Medical College at Metropolitan Hospital Center, New York, NY
| | - David Finlay
- Division of Vascular Surgery, Department of Surgery, The Mount Sinai Medical Center, New York, NY.
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5
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Oishi A, Yamamoto T, Kajimoto K, Amano A. Surgical Treatment of Celiacomesenteric Trunk Aneurysm: Report of 2 Cases. AMERICAN JOURNAL OF CASE REPORTS 2020; 21:e927077. [PMID: 33154344 PMCID: PMC7656087 DOI: 10.12659/ajcr.927077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Celiac artery aneurysm is very rare, and even is more uncommon in patients with celiacomesenteric trunks. With recent developments in diagnostic imaging, the detection of asymptomatic abdominal visceral aneurysms has increased. However, some abdominal visceral aneurysms are still first discovered after a rupture. An abdominal visceral aneurysm rupture can occur suddenly and lead to shock due to intraperitoneal hemorrhage. Two cases of celiac artery aneurysms that involved common celiacomesenteric trunks are presented. CASE REPORT Case 1 was a 63-year-old man who was referred to our facility for further study after a routine abdominal ultrasound identified an aneurysm in the superior mesenteric artery. Contrast-enhanced computed tomography (CT) scan revealed a 39-mm aneurysm in the celiacomesenteric trunk and its branches. Case 2 was a 32-year-old man who was referred to our facility after an abdominal ultrasound performed during a physical examination revealed a celiac artery aneurysm. Contrast-enhanced CT revealed a 31-mm aneurysm in the celiacomesenteric trunk and its branches. In both patients, the aneurysms were proximally located, and the distinctive anatomy of the celiacomesenteric trunk made endovascular treatment difficult. Open replacement and reconstructive surgery was performed to repair the aneurysms with grafts from the great saphenous vein. Both patients had uneventful postoperative courses. CONCLUSIONS The optimal treatment for the patients described was open surgical repair because the lower risk of occlusion of the visceral branch made it safer and more reliable than an endovascular approach.
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Affiliation(s)
- Atsumi Oishi
- Department of Cardiovascular Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Taira Yamamoto
- Department of Cardiovascular Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Kan Kajimoto
- Department of Cardiovascular Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Atsushi Amano
- Department of Cardiovascular Surgery, Juntendo University School of Medicine, Tokyo, Japan
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6
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Ratra A, Campbell S. Recurrent Mesenteric Ischemia from Celiomesenteric Trunk Stenosis. Cureus 2018; 10:e2751. [PMID: 30094108 PMCID: PMC6080742 DOI: 10.7759/cureus.2751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
A common origin of the celiac trunk and superior mesenteric artery (SMA), also termed as celiomesenteric trunk (CMT), is a rare occurrence. We report a rare case of symptomatic CMT stenosis requiring multiple interventions. The patient underwent an initial superior mesenteric artery bypass graft but required a subsequent endoluminal intervention. We present this case for the rarity of CMT stenosis and its potential to cause recurrent mesenteric ischemia. The treatment outcome in this patient suggests that revascularization of the SMA alone can result in adequate perfusion of the entire mesenteric bed and resolve symptoms of mesenteric ischemia including weight loss and food avoidance.
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Affiliation(s)
- Atul Ratra
- Texas Tech University Health Sciences Center, Lubbock, USA
| | - Samuel Campbell
- Department of General Surgery, Texas Tech University Health Sciences Center, Lubbock, USA
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7
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Lee SA, Jae HJ, Ahn S, Min SI, Ha J, Min SK. Endovascular Treatment of a Saccular Aneurysm in the Celiomesenteric Trunk: A Case Report and Review of Literature. Vasc Specialist Int 2018; 34:44-47. [PMID: 29984218 PMCID: PMC6027799 DOI: 10.5758/vsi.2018.34.2.44] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 05/21/2018] [Accepted: 05/21/2018] [Indexed: 11/20/2022] Open
Abstract
To present a world-first case of a successful endovascular treatment of a celiomesenteric trunk (CMT) aneurysm. A 45-year-old man had an asymptomatic saccular aneurysm in a rare anomaly of CMT. Endovascular multiple micro-coil embolization of the common hepatic artery, splenic artery and the aneurysm was done, followed by a stent-graft deployment in the superior mesenteric artery covering the orifice to the aneurysm. Postoperative course was uneventful. Only 21 cases have been previously reported in the literature, and all were treated by open surgeries. Endovascular therapy can be safely done in selected cases of a CMT aneurysm with sufficient collaterals to the liver and spleen.
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Affiliation(s)
- Shin Ae Lee
- Department of Surgery, Seoul National University College of Medicine, Seoul,
Korea
| | - Hwan Jun Jae
- Department of Radiology, Seoul National University College of Medicine, Seoul,
Korea
| | - Sanghyun Ahn
- Department of Surgery, Seoul National University College of Medicine, Seoul,
Korea
| | - Sang-il Min
- Department of Surgery, Seoul National University College of Medicine, Seoul,
Korea
| | - Jongwon Ha
- Department of Surgery, Seoul National University College of Medicine, Seoul,
Korea
| | - Seung-Kee Min
- Department of Surgery, Seoul National University College of Medicine, Seoul,
Korea
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8
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Armstrong PJ, Franklin DP. Superior Mesenteric Artery Branch Aneurysm with Absence of the Celiac Trunk. Vascular 2016; 14:109-12. [PMID: 16956480 DOI: 10.2310/6670.2006.00015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Superior mesenteric artery and pancreaticoduodenal artery aneurysms are rare. Agenesis of the celiac axis has only been reported four times. The reported etiologies of superior mesenteric artery and branch artery aneurysms include infection, atherosclerosis, inflammatory processes such as pancreatitis, dissection, collagen vascular disorders, polyarteritis nodosa, and trauma. We report an aneurysm of the superior mesenteric artery (SMA) branch, the inferior pancreaticoduodenal artery, arising in a patient with congenital absence of the celiac trunk. The patient presented with intermittent left upper quadrant pain without weight loss or change in bowel habits. The aneurysm was identified on abdominal computed tomography scan with angiographic confirmation of the aberrant anatomy. The patient was treated by aneurysmectomy and pancreaticoduodenal artery reconstruction with an interposition vein graft from the SMA. The patient recovered without complications and is asymptomatic with a patent vein graft 2 years after operation.
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Affiliation(s)
- Peter J Armstrong
- Section of Vascular Surgery, Geisinger Medical Center, Danville, PA,
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9
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VonDerHaar RJ, Shah A, Nissen NN, Gewertz BL. Primary intra-aneurysmal surgical repair of a celiomesenteric trunk aneurysm. J Vasc Surg Cases 2015; 1:50-52. [PMID: 31724576 PMCID: PMC6849929 DOI: 10.1016/j.jvsc.2014.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Accepted: 11/18/2014] [Indexed: 12/04/2022] Open
Abstract
We describe the surgical management of an asymptomatic 3-cm saccular aneurysm originating from a celiomesenteric trunk in a 45-year-old man. Surgical management was influenced by the location of the aneurysm, involving hepatic, splenic, and superior mesenteric arterial branches, by the young age of the patient, which made use of a synthetic graft less ideal, and by the lack of endovascular options.
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Affiliation(s)
- R Jason VonDerHaar
- Section of General Surgery, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, Calif
| | - Aamir Shah
- Section of Vascular Surgery, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, Calif
| | - Nicholas N Nissen
- Section of Hepatobiliary Surgery, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, Calif
| | - Bruce L Gewertz
- Section of Vascular Surgery, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, Calif
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10
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Lipari G, Cappellari TF, Giovannini F, Pancheri O, Piovesan R, Baggio E. Treatment of an aneurysm of the celiac artery arising from a celiomesenteric trunk. Report of a case. Int J Surg Case Rep 2015; 8C:45-8. [PMID: 25618400 PMCID: PMC4353963 DOI: 10.1016/j.ijscr.2014.12.037] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 12/22/2014] [Accepted: 12/27/2014] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Visceral artery aneurysms (VAA) are rare, frequently present as a life-threatening emergency and are often fatal. The celiacomesenteric trunk (CMT), a common origin of the celiac trunk (CT) and the superior mesenteric artery (SMA) from abdominal aorta, is quite rare. Aneurysms that involve this celiomesenteric anomaly are even rarer and in the last 32 years have been reported in only 20 cases in the literature. PRESENTATION OF CASE We describe a case with 30mm aneurysm arising from a CMT. In general, an aneurysm that is 20mm or greater in size is considered to be significant enough to warrant treatment. Abdominal VAA sometimes can be treated with low-invasive procedures: our patient required open surgical repair with the celiac artery replanted on to the aorta. DISCUSSION The clinical course was complicated only by an increase of hepatic cytolysis enzymes, and by a low output pancreatic fistula, treated conservatively. The patient was discharged on the fifteenth postoperative day. One month after discharge, imaging revealed a good patency of all reconstructed arteries. In the subsequent 36-month follow-up period, the patient reported no clinical episodes. CONCLUSION Our finding of a very rare case of a celiomesenteric anomaly with a concurrent aneurysm is extremely rare (20 cases in word literature in the last 32 years). The feasibility of the endovascular approach for aneurysms originating from the common celiomesenteric trunk depends mainly on aneurysmal location, diameter and neck size. In case of specific unfit anatomy, a careful surgical treatment can ensure the best results.
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Affiliation(s)
- G Lipari
- Vascular and Endovascular Unit, Surgical and Oncological Department, University of Verona, Verona, Italy
| | - T F Cappellari
- Vascular and Endovascular Unit, Surgical and Oncological Department, University of Verona, Verona, Italy
| | - F Giovannini
- Vascular and Endovascular Unit, Surgical and Oncological Department, University of Verona, Verona, Italy
| | - O Pancheri
- Vascular and Endovascular Unit, Surgical and Oncological Department, University of Verona, Verona, Italy
| | - R Piovesan
- Vascular and Endovascular Unit, Surgical and Oncological Department, University of Verona, Verona, Italy
| | - E Baggio
- Vascular and Endovascular Unit, Surgical and Oncological Department, University of Verona, Verona, Italy
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11
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Sakakibara K, Shindo S, Matsumoto M, Yoshida Y, Kimura M, Honda Y, Kamiya K, Katsu M, Kaga S, Suzuki S. Splenic artery aneurysm of the hepatosplenomesenteric trunk. Ann Vasc Dis 2014; 6:730-3. [PMID: 24386023 DOI: 10.3400/avd.cr.13-00057] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Accepted: 08/15/2013] [Indexed: 11/13/2022] Open
Abstract
We herein report the case of a splenic artery aneurysm with a hepatosplenomesenteric trunk that presented in a pregnant woman. Catheter embolization was not performed due to the wide neck of the aneurysm and its close location to the trunk indicates a high risk of mesenteric trunk thrombosis. We instead performed surgical resection of the aneurysm after successful delivery of the infant by Caesarian section. The splenic artery was reconstructed by side-to-end anastomosis with the common hepatic artery.
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Affiliation(s)
- Kenji Sakakibara
- Department of Surgery (II), Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Shunya Shindo
- Department of Cardiovascular Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Masahiko Matsumoto
- Department of Surgery (II), Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Yukiyo Yoshida
- Department of Surgery (II), Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Mitsuhiro Kimura
- Department of Surgery (II), Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Yoshihiro Honda
- Department of Surgery (II), Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Kentaro Kamiya
- Department of Surgery (II), Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Masatake Katsu
- Department of Surgery (II), Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Shigeaki Kaga
- Department of Surgery (II), Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Shoji Suzuki
- Department of Surgery (II), Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
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12
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Ricciardi M, Martino R, Assad EA. IMAGING DIAGNOSIS-CELIACOMESENTERIC TRUNK AND PORTAL VEIN HYPOPLASIA IN A PIT BULL TERRIER. Vet Radiol Ultrasound 2013; 55:190-4. [DOI: 10.1111/vru.12062] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Accepted: 05/04/2013] [Indexed: 11/28/2022] Open
Affiliation(s)
- Mario Ricciardi
- “Pingry” Veterinary Hospital; via Medaglie d'Oro 5 Bari Italy
| | - Rosmara Martino
- “Pingry” Veterinary Hospital; via Medaglie d'Oro 5 Bari Italy
| | - Eyad Abu Assad
- “Pingry” Veterinary Hospital; via Medaglie d'Oro 5 Bari Italy
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13
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Higashiyama H, Yamagami K, Fujimoto K, Koshiba T, Kumada K, Yamamoto M. Open surgical repair using a reimplantation technique for a large celiac artery aneurysm anomalously arising from the celiomesenteric trunk. J Vasc Surg 2011; 54:1805-7. [PMID: 21803520 DOI: 10.1016/j.jvs.2011.05.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2011] [Revised: 05/02/2011] [Accepted: 05/07/2011] [Indexed: 10/17/2022]
Abstract
Celiac artery aneurysms anomalously arising from the celiomesenteric trunk (hepatosplenomesenteric trunk) are rare, with only four patients reported thus far. Surgical intervention for this condition is challenging, particularly when the aneurysm is large and in a retropancreatic location. We report an open repair surgery in a 54-year-old asymptomatic man who presented with a saccular calcified aneurysm (diameter, 4.0 cm) of the celiac artery originating from the celiomesenteric trunk. Our technique involved minimal dissection of the surrounding vessels and complete aneurysm resection, along with revascularization of the hepatic, splenic, and superior mesenteric arteries with a single anastomosis.
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14
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Lee V, Alvarez MD, Bhatt S, Dogra VS. Median arcuate ligament compression of the celiomesenteric trunk. J Clin Imaging Sci 2011; 1:8. [PMID: 21915389 PMCID: PMC3169899 DOI: 10.4103/2156-7514.75260] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2010] [Accepted: 12/15/2010] [Indexed: 11/04/2022] Open
Abstract
Median arcuate ligament (MAL) syndrome is a controversial condition characterized by compression of the celiac trunk and symptoms of intestinal angina. We present a case of MAL compressing the celiomesenteric trunk, a rare variation. We report computed tomography (CT) angiography and three-dimensional reconstructions of this rare phenomenon.
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Affiliation(s)
- Victor Lee
- Department of Radiology, New York Medical College, Valhalla, NY, USA
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15
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Guntani A, Yamaoka T, Kyuragi R, Honma K, Iwasa K, Matsumoto T, Nishizaki T, Maehara Y. Successful treatment of a visceral artery aneurysm with a celiacomesenteric trunk: report of a case. Surg Today 2010; 41:115-9. [PMID: 21191702 DOI: 10.1007/s00595-010-4268-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2009] [Accepted: 02/08/2010] [Indexed: 02/01/2023]
Abstract
A celiacomesenteric trunk is an anomaly in which the celiac and superior mesenteric arteries have a common origin from the aorta. This structure accounts for less than 1% of all visceral artery anomalies, and is estimated to have an incidence of 0.25%. Aneurysms involving a celiacomesenteric trunk are exceptionally rare. We herein report our treatment modality for an 82-year-old man with a visceral artery aneurysm involving a celiacomesenteric trunk. The aneurysm was resected, and the superior mesenteric, splenic, and common hepatic arteries were successfully reconstructed.
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Affiliation(s)
- Atsushi Guntani
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
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16
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Wang Y, Chen P, Shen N, Yang JT, Chen JH, Zhang WG. Celiomesenteric trunk with concurrent aneurysm: report of a case. Surg Today 2010; 40:477-81. [PMID: 20425555 DOI: 10.1007/s00595-009-4164-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2009] [Accepted: 10/13/2009] [Indexed: 02/07/2023]
Abstract
This report describes a rare case of a common celiomesenteric anomaly with a concurrent aneurysm demonstrated by contrast-enhanced multidetector computed tomography (MDCT) angiography. The patient, a 53-year-old man, had no abdominal pain or discomfort. Abdominal CT scanning was performed because of hypoglycemia. Celiac digital subtraction angiography (DSA) was carried out 10 days after CT angiography. The CT angiographic images clearly showed a saccular aneurysm originating from the bifurcation of a common celiomesenteric trunk. The origin and course of the hepatic, splenic, and superior mesenteric arteries were also visualized. These findings were confirmed by intraarterial DSA. The lesion was resected surgically because of the risk of a rupture of the aneurysm, and the superior mesenteric artery was replanted into the celiomesenteric trunk.
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Affiliation(s)
- Yi Wang
- Department of Radiology, Third Affiliated Hospital and Research Institute of Surgery, Third Military Medical University, Chongqing, 400042, PR China
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17
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Reconstructive surgery for a fusiform common celiomesenteric trunk aneurysm and coexistent abdominal aortic aneurysm: report of a case. Surg Today 2009; 39:55-8. [PMID: 19132470 DOI: 10.1007/s00595-008-3784-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2007] [Accepted: 03/18/2008] [Indexed: 10/21/2022]
Abstract
A celiomesenteric trunk (CMT) accounts for fewer than 1% of all visceral artery anomalies. Aneurysms involving a CMT are exceptionally rare: our search of the literature found only eight cases reported. We treated a 73-year-old man with both a fusiform CMT aneurysm and an abdominal aortic aneurysm (AAA). The celiac artery and superior mesenteric artery were reconstructed by performing a retrograde prosthetic-graft bypass originating from the right limb of the bifurcated aortic graft used to repair the AAA. To our knowledge, this is the first report of successful surgical treatment of a CMT aneurysm and coexistent AAA.
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18
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Mammano E, Cosci M, Zanon A, Picchi G, Tessari E, Pilati P, Nitti D. Celiomesenteric trunk aneurysm. Ann Vasc Surg 2008; 23:257.e7-10. [PMID: 18809283 DOI: 10.1016/j.avsg.2008.08.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2007] [Revised: 05/11/2008] [Accepted: 08/11/2008] [Indexed: 11/29/2022]
Abstract
A celiomesenteric trunk (CMT) is an extremely rare anatomic variant that consists of celiac and superior mesenteric arteries having a common origin from the aorta. CMT accounts for less than 1% of all splanchnic artery anomalies. Aneurysm involving a CMT is an even rarer vascular abnormality, and, to our knowledge, only eight cases of CMT aneurysm have been reported in literature. We describe a case of the incidental finding of CMT aneurysm in an asymptomatic patient. It was found after dorsolumbar column radiography and successive computed tomography and arteriography confirmed the diagnosis. Even if asymptomatic, we decided to repair it surgically with aneurysmectomy and suture of the neck due to risk of rupture.
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Affiliation(s)
- Enzo Mammano
- Department of Oncological and Surgical Sciences, University of Padova, Padova, Italy.
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19
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Affiliation(s)
- Audra A Duncan
- Division of Vascular Surgery, Mayo Clinic Rochester, 200 First Street SW, Rochester, MN 55902, USA.
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20
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Petscavage JM, Maldjian P. Celiomesenteric trunk: two variants of a rare anomaly. ACTA ACUST UNITED AC 2008; 51 Suppl:B306-9. [PMID: 17991092 DOI: 10.1111/j.1440-1673.2007.01824.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The celiomesenteric trunk is a rare congenital vascular anomaly characterized by a common origin of the celiac axis and superior mesenteric artery. We report two variants: one in which the left gastric artery arises from a short common trunk and a second where the left gastric artery originates directly from the aorta above the common trunk. We discuss a possible embryologic mechanism for formation of these variants and the clinical implications. These cases also illustrate the ability of multidetector CT to provide quality images of such vascular anomalies.
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Ayers NP, Zacharias SJ, Abu-Fadel MS, Hennebry TA. Successful use of blunt microdissection catheter in a chronic total occlusion of a celiomesenteric artery. Catheter Cardiovasc Interv 2007; 69:546-9. [PMID: 17192962 DOI: 10.1002/ccd.20954] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Chronic mesenteric ischemia is often a disabling condition associated with intestinal angina, weight loss, and sitophobia (a morbid aversion of food). Significant stenosis of two of the three main arteries of the gut is usually required to produce symptoms. Surgical therapy has included reimplantation and bypass grafting, usually with synthetic conduits and occasionally endarterectomy. Newer techniques have made endovascular treatment an emerging modality in managing some of the difficult lesions in the mesenteric circulation that cause chronic mesenteric ischemia. We describe the first reported case of blunt microdissection using a Frontrunner XP(R) CTO Catheter (Lumend, Redwood City, CA) to successfully cross, subsequently wire and stent a four-year-old chronic total occlusions in a celiac trunk, which also gave origin to the superior mesenteric artery.
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Affiliation(s)
- N P Ayers
- Cardiovascular Section, Department of Internal Medicine, University of Oklahoma Health Sciences Center, 920 Stanton L. Young Boulevard, Oklahoma City, OK 73104, USA
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Matsuda H, Ogino H, Ito A, Sasaki H, Minatoya K, Higashi M, Yagihara T, Kitamura S. Aneurysm of the celiac artery arising from a celiomesenteric trunk. J Vasc Surg 2006; 44:660. [PMID: 16950452 DOI: 10.1016/j.jvs.2005.04.050] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2005] [Accepted: 04/26/2005] [Indexed: 10/24/2022]
Affiliation(s)
- Hitoshi Matsuda
- Department of Cardiovascular Surgery, National Cardiovascular Center, Suita, Japan.
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Ciçekcibaşi AE, Uysal II, Seker M, Tuncer I, Büyükmumcu M, Salbacak A. A rare variation of the coeliac trunk. Ann Anat 2005; 187:387-91. [PMID: 16163851 DOI: 10.1016/j.aanat.2005.02.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The hepatic, splenic and Left gastric arteries are considered as the "main classic branches" of the coeliac trunk. During the routine dissections in the laboratory of the Anatomy Department in a 62-year-old male cadaver, a rare variation, a coeliacomesenteric trunk was observed. This trunk gave rise to the left gastric, the common hepatic, the splenic, the left gastro-epiploic, the right and left inferior phrenic arteries. The developmental and clinical significance of this anomalous vessel is discussed.
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Ailawadi G, Cowles RA, Stanley JC, Eliason JL, Williams DM, Colletti LM, Henke PK, Upchurch GR. Common celiacomesenteric trunk: aneurysmal and occlusive disease. J Vasc Surg 2004; 40:1040-3. [PMID: 15557926 DOI: 10.1016/j.jvs.2004.08.028] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Eighteen patients (14 men, 4 women), ages 24 to 77 years, with a common celiacomesenteric trunk (CMT) were treated between 1965 and 2004 at the University of Michigan. Four patients had CMT aneurysmal or occlusive disease that led to operative treatment. Pertinent arteriographic findings in these 4 patients included a CMT aneurysm (n = 2), an occluded proximal CMT (n = 1), and a type III aortic dissection that was compressing the CMT (n = 1). Therapy in these 4 patients included placement of a polytetrafluoroethylene bypass graft from the supraceliac aorta to the CMT (n = 2) or a Dacron bypass graft from a thoracoabdominal bypass to the CMT (n = 1), and endovascular fenestration of the septum between the true and false lumens of an aortic dissection at the level of the CMT (n = 1).
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Affiliation(s)
- Gorav Ailawadi
- Section of Vascular Surgery, Department of Surgery, University of Michigan Medical Center, Ann Arbor, MI 48109, USA
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