Ruptured pancreaticoduodenal artery aneurysms and pheochromocytoma in a pregnant patient with neurofibromatosis

Serleth, Hans J.; Cogbill, Thomas H.; Gundersen, Sigurd B.

doi:10.1016/s0039-6060(98)70081-9

Cited by 19 publications

(5 citation statements)

References 3 publications

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“…Arterial involvement is most common, although venous involvement has also been reported (Lehrnbecher et al 1994 ). These lesions frequently occur in the renal arteries, but may also occur in the cerebral or visceral arteries (Criado et al 2002 ; Serleth et al 1998 ; Westenend et al 1994 ). The exact frequency of vasculopathy in patients with NF1 is unknown and many patients with vasculopathy remain asymptomatic throughout their lives (Friedman et al 2002 ).…”

Section: Natural Historymentioning

confidence: 99%

Neurofibromatosis Type 1 in Genetic Counseling Practice: Recommendations of the National Society of Genetic Counselors

Radtke

Sebold

Allison

et al. 2007

Journal of Genetic Counseling

101

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The objective of this document is to provide recommendations for the genetic counseling of patients and families undergoing evaluation for neurofibromatosis type 1 (NF1) or who have received a diagnosis of NF1. These recommendations are the opinions of a multi-center working group of genetic counselors with expertise in the care of individuals with NF1. These recommendations are based on the committee's clinical experiences, a review of pertinent English language medical articles, and reports of expert committees. These recommendations are not intended to dictate an exclusive course of management, nor does the use of such recommendations guarantee a particular outcome. These recommendations do not displace a health care provider's professional judgment based on the clinical circumstances of an individual patient.

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Section: Natural Historymentioning

confidence: 99%

Neurofibromatosis Type 1 in Genetic Counseling Practice: Recommendations of the National Society of Genetic Counselors

Radtke

Sebold

Allison

et al. 2007

Journal of Genetic Counseling

101

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“…Celiac axis lesion is the most common cause of true PAAAs formation. However, many other etiologies have been described, including vasculitis [ 1 ], fibrodysplasia [ 2 ], and congenital collagen disorders [ 3 ]. True PAAAs are rare and therefore literature covering this entity is scarce.…”

Section: Introductionmentioning

confidence: 99%

Aneurysms of Peripancreatic Arterial Arcades Coexisting with Celiac Trunk Stenosis or Occlusion: Single Institution Experience

Antoniak

Grabowska-Derlatka

Nawrot

et al. 2017

BioMed Research International

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Introduction. True aneurysms of peripancreatic arterial arcades (PAAAs) are rare. Most of them coexist with celiac axis stenosis/occlusion due to median arcuate ligament (MAL) compression or atherosclerosis. The aim of this study was to evaluate the cause of celiac axis lesion and characterize the anatomy of the aneurysms. These findings may have important management implications. Material and Methods. A retrospective analysis of 15 patients with true PAAAs was performed. The diagnosis was established by contrast-enhanced CT, using a 64-MDCT scanner. We evaluated the most probable cause of celiac axis lesion. Aneurysms were characterized by their number, location, size, and morphology. Location of the aneurysms was classified either as pancreaticoduodenal arteries (PDA) or as dorsal pancreatic arteries (DPA) as they may represent different collateral pathways between superior mesenteric artery and celiac trunk. Results. A total of 32 true PAAAs were identified. Celiac trunk was occluded in 12 patients and critically narrowed in 3 patients. Celiac axis lesion was categorized as secondary to MAL compression in 14 cases and due to atherosclerosis in 1 case. The most common location of the aneurysms was inferior pancreaticoduodenal arteries. Only in 1 case aneurysms involved both PDA and DPA. Conclusions. Coexistence of PAAAs with celiac axis compression as well as involvement of either PDAs or DPAs has important therapeutic implications. The uninvolved collateral pathway may be sufficient to preserve effective circulation in celiac trunk branches in case of resection or embolization of the aneurysms. However, further studies are crucial to confirm our findings.

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“…Additionally, although the possibility that an existing PAA aneurysm had ruptured cannot be completely ruled out, this was considered unlikely, as there was no median arcuate ligament stenosis on celiac angiography and no aneurysm on previous CT images. Even if the present case involved a ruptured PAA aneurysm, it is still of interest, as there are only 2 reported cases of ruptured pancreaticoduodenal artery aneurysm associated with NF1 (Serleth et al 1998 ; Fukushima et al 2020 ).…”

Section: Discussionmentioning

confidence: 83%

Spontaneous rupture of the pancreatic arcade artery caused by neurofibromatosis type 1 successfully treated using emergency transcatheter arterial embolization, partial intra-aortic balloon occlusion, and stent graft placement: a case report and review of the literature

et al. 2020

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Background: Vascular abnormalities in neurofibromatosis type 1 (NF1) are rare, but are the second leading cause of death in persons with NF1. In NF1 vasculopathy (NF-V), fatal bleeding due to a spontaneous arterial rupture sometimes occurs. Ruptured extracranial arteries in patients with NF1 often involve thoracic vessels, such as the intercostal and subclavian arteries; very few reports exist regarding the abdominal region. Herein, we present the first case of intraperitoneal bleeding due to spontaneous pancreatic arcade artery (PAA) rupture associated with NF1, successfully treated by transcatheter arterial embolization (TAE) combined with stent-graft placement and partial intra-aortic balloon occlusion (IABO). Case presentation: A 40-year-old woman complained of back and abdominal pain. Upon admission, her blood pressure was 85/41 mmHg and heart rate was 129 beats/min. Computed tomography (CT) showed large intraperitoneal bleeding due to PAA rupture. After CT scanning, her systolic blood pressure decreased to 50 mmHg. Therefore, we performed emergency TAE with partial IABO. She was treated by TAE of the anterior superior pancreaticoduodenal artery, anterior inferior pancreaticoduodenal artery, and inferior pancreaticoduodenal artery. However, even after TAE, minor extravasation around the superior mesenteric artery continued, and her vital signs remained unstable. Stent-graft placement was selected to stop the haemorrhage, preserving normal blood flow of the superior mesenteric artery trunk. Excellent patency of the stent graft was confirmed on follow-up CT, and she was discharged on postoperative day 56.

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Ruptured pancreaticoduodenal artery aneurysms and pheochromocytoma in a pregnant patient with neurofibromatosis

Cited by 19 publications

References 3 publications

Neurofibromatosis Type 1 in Genetic Counseling Practice: Recommendations of the National Society of Genetic Counselors

Neurofibromatosis Type 1 in Genetic Counseling Practice: Recommendations of the National Society of Genetic Counselors

Aneurysms of Peripancreatic Arterial Arcades Coexisting with Celiac Trunk Stenosis or Occlusion: Single Institution Experience

Spontaneous rupture of the pancreatic arcade artery caused by neurofibromatosis type 1 successfully treated using emergency transcatheter arterial embolization, partial intra-aortic balloon occlusion, and stent graft placement: a case report and review of the literature

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