Surgical treatment of celiomesenteric trunk aneurysm-7 case report

Abstract

The celiomesenteric trunk is a rare anomaly characterized by a common origin of the celiac axis and superior mesenteric artery from the aorta, which accounts for less than 1% of all celiac artery anomalies, so the aneurysm occurred in such trunk is even rarer. There have been few reports on how to diagnose and deal with such malformed celiomesenteric trunk aneurysms till now. This paper tries to summarize the experience of how to expose and excise such kind of aneurysm according to the seven cases' data. The clinic data were collected retrospectively. There were seven cases with celiomesenteric trunk aneurysm from February 2000 to February 2013, including 5 males and 2 females aged 35~62. The operations were done including aneurysm resection and vascular reconstruction under general anesthesia. The operated patients were followed-up at the sixth month and each year post operation. The vascular stomas were detected or examined by Color Doppler Sonography, spiral Computed Tomography angiography (SCTA). The seven operated patients were cured and discharged from hospital, and they were followed up for 3~10 years (mean time 5 years), with four patients being followed up longer than 5 years. No sign of intestinal ischemia or hepatic ischemia or splenic ischemia was found, and no image of anastomosis stricture or stenosis was found during the follow-up. Five patients are alive now while two patients were dead, with one dying of large area myocardial infarction unexpectedly at 6 years post operation and the other dying of cerebral infarction abruptly at 4 years post operation. It is an effective and safe method to treat the celiomesenteric trunk aneurysm by using by-pass operation with artificial blood vessels, originating from inferior kidney aorta to visceral arteries including hepatic artery, splenic artery and superior mesenteric artery. Its short-term and middle-term effects are relatively better.

Transcatheter Arterial Embolization of IgG4-Related Inflammatory Celiacomesenteric Trunk Aneurysm: A Case Report

“…A celiacomesenteric trunk, the common origin of the celiac trunk and the superior mesenteric artery (SMA) from the abdominal aorta, is not commonly encountered. As one might expect, IgG4-related aneurysms involving this arterial anomaly are also uncommon [8][9][10]. This report describes a case of IgG4-related celiacomesenteric trunk aneurysm treated using transcatheter arterial embolization.…”

“…As one might expect, aneurysms involving this celiacomesenteric anomaly are not commonly encountered. Open surgery is the first-line treatment [8][9][10]. Nevertheless, few reports to date have described endovascular intervention.…”

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

“…A CMT aneurysm is even rarer. A literature search revealed only 21 cases during the last 47 years [ 1 – 15 ], since Stanley et al [ 3 ] reported the first case treated by open repair. All the reported cases were treated by open surgical repair.…”

“…Interestingly 15 cases were from Far East Asia (Korea, Japan, and China), and 7 cases were from Western countries (USA, Italy, and France). Excluding a case series of Wang et al [ 15 ] with insufficient data, the characteristics of the CMT aneurysm were analyzed (n=15). The morphology was mainly saccular in 12 (80%), or fusiform in 3 (20%).…”

Persistence of Abdominal Pain: Did You Check for Mesenteric Vessels?

“…CMT aneurysm is even rarer and occurs in only 0.25% of all visceral artery anomalies. For example, in the last 52 years, only 26 cases have been reported in the literature [ 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ]. Depending on the location and size of the aneurysm, the mortality rate is 10–90% after rupture.…”