Celiomesenteric trunk with concurrent aneurysm: Report of a case

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.

Endovascular Repair of an Aneurysm Arising from a Celiomesenteric Trunk

“…In the present case, patients with abdominal visceral artery aneurysms often have no physical symptoms from the abnormalities, and approximately 80% of these cases are only found after rupture. 7 Mortality of ruptured visceral aneurysms reported in the literature varies from 8% to 25%. 4e10 Because of poor prognosis after rupture, treatment of CMT aneurysms is required even for asymptomatic patients.…”

A case of celiacomesenteric trunk in a Tanzanian man

“…Embryologically therefore, the occurrence of celiacomesenteric trunk can be explained by regression of the 10th root and persistence of both the 13th root and the anterior anastomosis. The diagnosis celiacomesenteric trunk has often been reported during autopsy or accidentally during angiography or abdominal computed tomography scanning [5,13]. This anomaly have been reported to be associated with clinical conditions like chronic occlusive disease, compression by abdominal aorta aneurysm [14], celiac compression syndrome [15], or rarely large gastrointestinal infarction due to thrombosis of the celiacomesenteric trunk [4].…”

Open surgical repair using a reimplantation technique for a large celiac artery aneurysm anomalously arising from the celiomesenteric trunk

“…[3][4][5][6][7][8][9][10][11][12][13][14][15] The CMT is clinically important in cases of deteriorated vessels caused by aneurysms, 3-15 stenosis, 9,10 and occlusion 10 because blood supply from the celiac artery and SMA is impaired. Of the 18 CMT aneurysms that have been reported, [3][4][5][6][7][8][9][10][11][12][13][14][15] only four were of an anomalous origin of the celiac artery from the CMT, identical to our patient. 5,9,11,14 The remaining 14 were aneurysms located in the CMT itself, including one at the origin of the CMT 13 and 13 at the bifurcation of the CMT into the celiac artery and SMA.…”

“…5,9,11,14 The remaining 14 were aneurysms located in the CMT itself, including one at the origin of the CMT 13 and 13 at the bifurcation of the CMT into the celiac artery and SMA. 3,4,[6][7][8]10,12,15 Because of the impairment of the dual vessel blood supply and poor collateral circulation, CMT aneurysms, including celiac artery aneurysms from the CMT, were all successfully treated with open repair and simultaneous revascularization. [3][4][5][6][7][8][9][10][11][12][13][14][15] Aneurysmectomy with direct anastomosis or bypass was performed in seven patients in whom the aneurysm diameter was Ͻ40 mm, whereas aneurysmorrhaphy with suturing of the neck or aneurysm ablation with bypass was performed in 11 in which the aneurysm was larger.…”

“…5,9,11,14 Surgical interventions for CMT aneurysms involve resection and vascular reconstruction, despite their problematic anatomic locations. [3][4][5][6][7][8][9][10][11][12][13][14][15] Because the blood supply from the celiac artery and SMA is simultaneously interrupted, there is a high risk of end-organ failure. [3][4][5][6][7][8][9][10][11][12][13][14][15] We report a patient who underwent a successful complete aneurysm resection with total revascularization by using a reimplantation technique for an aneurysm (diameter, 4.0 cm) of an anomalous celiac artery originating from the CMT.…”