Endovascular Treatment of a Saccular Aneurysm in the Celiomesenteric Trunk: A Case Report and Review of Literature

Lee, Shin Ae; Jae, Hwan Jun; Ahn, Sungyoon; Min, Sang Il; Ha, Jong‐Won; Min, Seung-Kee

doi:10.5758/vsi.2018.34.2.44

Cited by 4 publications

(5 citation statements)

References 16 publications

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“…Visceral artery aneurysm is the third most common intra-abdominal aneurysm after aneurysms of the aortic and iliac arteries [1]. However, visceral artery aneurysm is rare, and the incidence is 0.1% to 0.2% of the population [2,3]. The splenic artery is the most frequent site of aneurysm, and splenic artery aneurysm accounts for approximately 60% of the frequency in visceral artery aneurysms [4].…”

Section: Introductionmentioning

confidence: 99%

Inferior Pancreaticoduodenal Artery Aneurysm Related with Groove Pancreatitis Persistently Repeated Hemosuccus Pancreaticus Even After Coil Embolization

et al. 2019

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Patient: Male, 58 Final Diagnosis: Inferior pancreaticoduodenal artery aneurysm Symptoms: Bleding Medication: — Clinical Procedure: Pancreaticoduodenectomy Specialty: Surgery Objective: Rare disease Background: Aneurysm of the inferior pancreaticoduodenal artery (IPDA) is rare among visceral artery aneurysms. Aneurysm and/or pancreatitis may have a causal relation with hemosuccus pancreaticus (HP). HP causes an obscure bleeding in the digestive tract, and this rare disease may lead to life-threatening condition. Although interventional radiology is generally employed as the initial treatment for visceral aneurysms, aneurysmic recanalization is a critical problem. Case Reports: A 58-year-old male was incidentally diagnosed as groove pancreatitis, and his pancreatitis was successfully treated by conservative management. One year later, an IPDA aneurysm was detected in image studies. Gastrointestinal bleeding was objectively observed, and a diagnosis of asymptomatic HP was made. Arteriopancreatic duct fistula was suspected, but was not identified. Coil embolization was successfully completed. Six months later, he suffered a relapse of HP, and visited our emergency unit. Pseudocystic lesion around metallic coils were confirmed. Subtotal stomach-preserving pancreaticoduodenectomy without any extended resections was performed. Intentional dissections of nerve plexuses and lymph nodes were all waived. Even a pancreatography of the resected specimen did not clarify his arterio-pancreatic duct fistula. He was discharged at postoperative day 10, and smoothly returned to his work. Conclusions: Pancreatic juice-related complications after advanced pancreaticoduodenectomy for malignancies are often intractable. However, simple pancreaticoduodenectomy which omits extended resections and intentional dissections is safe and feasible for benign diseases. After the initial interventional radiology for pancreatic aneurysms, an elective pancreatic surgery should be considered to avoid unwanted recanalization and refractory HP.

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Section: Introductionmentioning

confidence: 99%

Inferior Pancreaticoduodenal Artery Aneurysm Related with Groove Pancreatitis Persistently Repeated Hemosuccus Pancreaticus Even After Coil Embolization

et al. 2019

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“…Visceral arterial aneurysms are the third most common intra-abdominal aneurysms after aneurysms of the aorta and iliac arteries [1]. Even so, visceral arterial aneurysms are rare, with an incidence of 0.1–0.2% among the global population [2,3]. The splenic artery (SA) is the most frequent site of visceral aneurysms, and SA aneurysms (SAAs) account for approximately 60% of all visceral aneurysms [4].…”

Section: Introductionmentioning

confidence: 99%

Severely Calcified True Aneurysm: A Thought-Provoking Case of Solitary Origin and Postoperative Management

et al. 2019

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Patient: Male, 70 Final Diagnosis: Splenic artery aneurysm Symptoms: Asymptomatic Medication: — Clinical Procedure: Surgery and Endoscopy Specialty: Surgery Objective: Unknown ethiology Background: Visceral arterial aneurysms are rare. Most splenic arterial aneurysms (SAAs) are saccular and are in the distal third of the splenic artery. Suggested major causes of SAAs are atherosclerosis, pregnancy, and inflammation. We report the case of a patient who with a SAA extending almost the full length of his splenic artery. Case Report: A solitary true aneurysm that extended almost the entire length of the splenic artery was incidentally detected in an asymptomatic 70-year-old male patient with a history of myasthenia gravis and diabetes mellitus. His SAA was severely calcified, but other arteries showed no calcification. The aneurysm had been slightly enlarged toward the celiac artery for 2 years, and aneurysmectomy and splenectomy were performed. Vascular clips were carefully placed at the intact splenic artery without disturbing arterial flows from the celiac artery. Arterial branch from the SAA was ligated at an intact area, and the pancreatic capsule was densely adherent with the calcified aneurysm wall. The pancreas was preserved, although the pancreatic parenchyma was widely exposed during aneurysmectomy. Pathological examination revealed no atherosclerotic changes. Postoperatively, a pancreatic fistula developed, which was treated by placing an intraperitoneal drain and retrograde pancreatic drainage tube. Nevertheless, the intractable pancreatic fistula triggered a bacteriogenic infection, resulting in intraperitoneal abscess. Continuous local lavage via transnasal continuous infusion and endoscopic transgastric drainage was performed, until the fistula closed. He was healthy at 9 months after surgery. Conclusions: A SAA that had the rare form and solitary origin was treated. Continuous local lavage has a therapeutic potential for a pancreatic juice-related bacteriogenic complication.

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“…Lee et al [ 13 ] reported the first case of endovascular treatment for a celiomesenteric trunk (CMT) aneurysm. To commemorate the success of the first case of endovascular treatment of a CMT aneurysm, we reported the case using a cartoon of a giraffe, hoping for a good long-term prognosis ( Fig.…”

Section: ) Think Rational Behave Bravely: Record Innovative Ideas And...mentioning

confidence: 99%

“… Celiomesenteric trunk (CMT) aneurysm was treated by endovascular intervention, which appears like a giraffe’s head. Adapted from the article of Lee et al (Vasc Specialist Int 2018;34:44-47) [ 13 ]. …”

Section: Figmentioning

confidence: 99%

“…These cases are extremely rare to encounter, almost once in a lifetime, and reports from many researchers are important to define the clinical presentation and natural history of the disease. 5) Think rational, behave bravely: record innovative ideas and treatment of a rare vascular disease Lee et al [13] reported the first case of endovascular treatment for a celiomesenteric trunk (CMT) aneurysm. To commemorate the success of the first case of endovascular treatment of a CMT aneurysm, we reported the case using a cartoon of a giraffe, hoping for a good long-term prognosis (Fig.…”

Section: ) Report and Remind Readers Of An Unusual Presentation Of An...mentioning

confidence: 99%

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Endovascular Treatment of a Saccular Aneurysm in the Celiomesenteric Trunk: A Case Report and Review of Literature

Cited by 4 publications

References 16 publications

Inferior Pancreaticoduodenal Artery Aneurysm Related with Groove Pancreatitis Persistently Repeated Hemosuccus Pancreaticus Even After Coil Embolization

Inferior Pancreaticoduodenal Artery Aneurysm Related with Groove Pancreatitis Persistently Repeated Hemosuccus Pancreaticus Even After Coil Embolization

Severely Calcified True Aneurysm: A Thought-Provoking Case of Solitary Origin and Postoperative Management

When Encountering a Rare Vascular Disease, Report and Share your Experience: Six Reasons to Publish a Case Report in VSI

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