Successful Resection of an Aneurysm of the Pancreaticoduodenal Artery

Samson, Ian D.

doi:10.1177/153857448101500302

Cited by 9 publications

(1 citation statement)

References 5 publications

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“…Although there was no reported case of aneurysm reformation, this may reflect lack of long-term follow-up. Management in these patients included local resection, 2,8,12,[21][22][23][24][25][26][27][28][29][30] exclusion, 3,7 ligation, 16,20 endoaneurysmorrhaphy, 19,23 and embolization. 24 Revascularization of the celiac axis, 31 and section of the median arcuate ligament 6 without resection of the aneurysms led to a favorable outcome and postoperative angiography did not reveal any aneurysms, presumably because of thrombosis within the aneurysm.…”

Section: Discussionmentioning

confidence: 99%

Pancreaticoduodenal artery aneurysms associated with celiac axis stenosis due to compression by median arcuate ligament and celiac plexus

Suzuki¹,

Kashimura²,

Sato³

et al. 1998

Journal of Gastroenterology

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Celiac axis stenosis is frequently associated with pancreaticoduodenal artery aneurysms. Although the cause of stenosis was not clear in most of the reported cases, compression of the median arcuate ligament of the diaphragm was found to be responsible for the stenosis in 7 of 42 reported cases of this type of aneurysm. We report a case of aneurysm caused by compression of the median arcuate ligament of the diaphragm and celiac plexus. An asymptomatic 43-year-old Japanese man was admitted with a low echoic lesion in the uncus of pancreas. Computed tomographic scan and angiogram revealed stenosis of the celiac axis and two aneurysms in the inferior posterior pancreaticoduodenal artery. The celiac plexus and median arcuate ligament were divided surgically and normal flow was reestablished in the celiac axis. One of the aneurysms was resected and the afferent artery of the other aneurysm was ligated. In the setting of pancreaticoduodenal artery aneurysm associated with celiac axis stenosis, management of stenosis should be considered in addition to local treatment of the aneurysm. In this context, division of median arcuate ligament and celiac plexus or aorto-celiac bypass may normalize the flows in the pancreaticoduodenal arcade and could be effective in preventing aneurysm reformation.

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