Multiple aneurysms of the visceral arteries with migrating vascular bruit on postural change: A case report

Hatano, Ryo; Iwai, Takehisa; Goseki, Narihide; Kudo, Gyoetsu; Hiranuma, Susumu; Kojima, Shinichi; Murakami, Tadashige; Suzuki, Soji; Aoki, Nozomi

doi:10.1007/bf02468646

Cited by 15 publications

(6 citation statements)

References 6 publications

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“…[7][8][9][10][11][12][13][14][16][17][18][19]22,24,26 Transarterial embolization of the aneurysm has also been performed in four cases with success. This treatment is now performed on a wide range of visceral arterial aneurysms.…”

Section: Discussionmentioning

confidence: 99%

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Sonographic detection of an aneurysm of the gastroepiploic artery

Kato

Ishida

Komatsuda

et al. 2009

J of Clinical Ultrasound

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Gastroepiploic artery aneurysm (GEAA) is very rare.1 Furthermore, most GEAA cases are diagnosed after their rupture. We report a case of asymptomatic GEAA. The patient was a 61-year-old man. Sonography (US) revealed a 2-cm anechoic mass in the epigastrium near the anterior abdominal wall. Color Doppler US and contrast-enhanced US showed arterial flow within the mass leading to the diagnosisof visceral artery aneurysm. CT and angiography confirmed the diagnosis of right GEAA, and the aneurysm was treated successfully with embolization. Follow-up US 6 months later confirmed the absence of blood flow within the lesion.

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Section: Discussionmentioning

confidence: 99%

“…Clinical manifestations were generally similar to those of other visceral arterial aneurysms, with abdominal pain in 16/24 cases (67%). [7][8][9][10][11][12][13]14,17,[20][21][22][23][25][26][27] Abdominal imaging often begins with US. If necessary, color Doppler US is also used.…”

Section: Discussionmentioning

confidence: 99%

Sonographic detection of an aneurysm of the gastroepiploic artery

Kato

Ishida

Komatsuda

et al. 2009

J of Clinical Ultrasound

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“…Further aetiological factors contributing to visceral artery disease include atherosclerosis, fibromuscular dysplasia and pancreatitis. 6,11,12 Data compiled by Shanley et al regarding splanchic artery aneurysms (i.e. pancreaticoduodenal, gastroduodenal, superior mesenteric, inferior mesenteric and colic arteries) show that these present mostly in middle-aged men as unexplained abdominal pain with other gastrointestinal or systemic associations that vary between the individual arteries; for example, gastroduodenal artery aneurysms were found to be related to pancreatitis and biliary disease; superior mesenteric artery aneurysms were associated with hypertension and endocarditis.…”

Section: Discussionmentioning

confidence: 99%

“…The splenic artery is reported to be the visceral artery most commonly affected by aneurysmal dilatation, whereas the coeliac trunk 8 and the inferior mesenteric artery 9,10 are the least involved. Further aetiological factors contributing to visceral artery disease include atherosclerosis, fibromuscular dysplasia and pancreatitis 6,11,12 …”

Section: Discussionmentioning

confidence: 99%

Kehr's sign – a rare cause: Spontaneous phrenic artery rupture

Sutton

Marshall

White

et al. 2002

ANZ Journal of Surgery

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Pain referred to in the left shoulder along with left upper quadrant hyperaesthesia after splenic rupture is a well-recognized physical sign, and was originally described by Hans Kehr (1862Kehr ( -1916 in the late 19th century. 1 We describe a previously unreported case of Kehr's sign secondary to spontaneous rupture of the left inferior phrenic artery. CASE REPORTA 43-year-old woman was admitted as a surgical emergency patient with sudden onset left upper quadrant abdominal pain radiating to the left shoulder, which was exacerbated by coughing. On initial clinical examination the patient appeared well. She was haemodynamically stable with left upper quadrant abdominal pain but no signs of peritonitis. At this stage, her haemoglobin was 12.1 g/dL and her white cell count was 13.6; coagulation studies were normal. Erect chest and abdominal radiographs were unremarkable. An abdominal ultrasound scan demonstrated the presence of upper abdominal free fluid, and the spleen appeared enlarged and was surrounded by a mixed echogenic collection measuring approximately 10 cm in diameter. An initial diagnosis of spontaneous splenic rupture was made. She was managed conservatively with regular observation. The following morning, the patient had deteriorated with increasing abdominal pain, tachycardia and hypotension. Her haemoglobin was now 8.6 g/dL, so a transfusion was organized and an emergency laparotomy performed.Upon opening the peritoneal cavity, a small amount of fresh blood was seen anterior to the lesser curve of the stomach. The spleen appeared congested and there was a haematoma present in the transverse mesocolon and lesser sac. Upon re-inspection, the spleen had become displaced by a significant retroperitoneal haematoma, and it was thought that the patient had ruptured a splenic artery aneurysm (Fig. 1). The splenic artery was mobilized but it became immediately apparent that this was not the case. As the posterior wall of the lesser sac was incised there was 1.5 L of haematoma tracking behind the left triangular ligament. The left triangular ligament was mobilized and the haematoma was evacuated. A rupture of the left inferior phrenic artery was discovered on the inferior surface of the diaphragm and was under-run. The patient made an uneventful recovery and was discharged 4 days later. DISCUSSIONFew cases describing bleeding from the phrenic arteries have been documented. The phrenic arteries are vessels of complex anatomical arrangement characterized by their variable originfrom the aorta, coeliac trunk or renal arteries -and multiplicity of branches. 2,3 In a search of the literature, two articles were found which describe injury to these arteries by laceration: (i) following percutaneous needle lung biopsy presenting as a haemoperitoneum; 3 and (ii) as a complication of repairing pectus excavatum, 4 which presented as a haemothorax. Other rare cases of haemoperitoneum involving the phrenic arteries have been documented in which the underlying aetiology was attributed to aneurysmal dilatation of the vessel...

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“…Lebensdekade mit einem Geschlechtsverhältnis m : w von 3 : 1 betroffen [26]. Bis heute wurden insgesamt etwas mehr als 2.800 Fälle veröffentlicht, von denen 22 % als Notfall behandelt werden muûten [3,11,21,22]. So können Aneurysmen der Visceralarterien auf dem Boden einer fibromuskulären Dysplasie, hormoneller Einflüsse, wie Schwangerschaft, mykotischer Em-bolien und lokaler Entzündungsprozesse, bei Periarteriitis nodosa, traumatisch, aber auch bei Arteriosklerose entstehen [8,18,24,26].…”

Section: Diskussionunclassified

Symptomatisches Aneurysma der Arteria gastroepiploica dextra Fallbericht und Literaturübersicht

Walter

Opitz

2001

Chirurg

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Aneurysms of the splanchnic arteries have rarely been reported. Aneurysms of the splenic artery are the most common aneurysms of the splanchnic vessels, followed by the hepatic and the mesenteric artery. Aneurysms of the gastroepiploic vessels show an incidence of only 0.4%. Due to a rupture rate of nearly 90% they are of great clinical importance. Therefore treatment is indicated for every diagnosed aneurysm of the gastroepiploic artery. While for ruptured aneurysms a conventional operation is inevitable, for asymptomatic aneurysms laparoscopic or interventional therapy is an alternative.

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Multiple aneurysms of the visceral arteries with migrating vascular bruit on postural change: A case report

Cited by 15 publications

References 6 publications

Sonographic detection of an aneurysm of the gastroepiploic artery

Sonographic detection of an aneurysm of the gastroepiploic artery

Kehr's sign – a rare cause: Spontaneous phrenic artery rupture

Symptomatisches Aneurysma der Arteria gastroepiploica dextra Fallbericht und Literaturübersicht

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