True Aneurysm of the Pancreaticoduodenal Arteries: A Single Institution Experience

Katsura, Morihiro; Gushimiyagi, Masanori; Takara, Hiroaki; Mototake, Hidemitsu

doi:10.1007/s11605-010-1257-0

Cited by 31 publications

(27 citation statements)

References 19 publications

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“…Several aetiologies have been correlated with their pathogenesis. Infection, trauma from surgeries or endoscopic procedures, collagen diseases, and pancreatitis [8] form the basis for the formation of pseudoaneurysms which becomes more prevalent when the arcade is enlarged secondary to celiac trunk stenosis [9]. True aneurysms have been linked to flow redistribution from celiac trunk stenosis [9].…”

Section: Discussion and Evaluationmentioning

confidence: 99%

“…Infection, trauma from surgeries or endoscopic procedures, collagen diseases, and pancreatitis [8] form the basis for the formation of pseudoaneurysms which becomes more prevalent when the arcade is enlarged secondary to celiac trunk stenosis [9]. True aneurysms have been linked to flow redistribution from celiac trunk stenosis [9]. The high flow rate or kinetics of turbulent blood in the smaller branches of the SMA, as a result of divergent blood from the celiac trunk due to stenosis, increases the shear stress on the single endothelial layer of the intima, resulting in alteration of its biochemical profile, the development of erosion, and increased permeability.…”

Section: Discussion and Evaluationmentioning

confidence: 99%

“…In most reported cases, the cause of this stenosis is ambiguous. Of 12 reported cases with a known aetiology, 9 were attributed to median arcuate ligament compression and 3 were due to atherosclerosis, thrombosis, and agenesis of the celiac trunk, respectively [9]. …”

Section: Discussion and Evaluationmentioning

confidence: 99%

“…Modalities used for detection include contrast-enhanced multidetector-row CT, three-dimensional contrast-enhanced magnetic resonance angiography [11], and CT angiography with 3D reconstruction from thin section (0.6 mm–3 mm) acquisitions [9, 16]. In addition, CT angiography and magnetic resonance angiography are capable of routinely detecting aneurysms less than 1 cm in diameter [17].…”

Section: Discussion and Evaluationmentioning

confidence: 99%

“…With the presence of celiac trunk stenosis and the consequent divergent of retrograde blood from the SMA to the celiac territory, the arcade becomes engorged and easily visualized by SMA angiography and MRI kinetic studies [9, 14]. …”

Section: Discussion and Evaluationmentioning

confidence: 99%

See 4 more Smart Citations

Pancreaticoduodenal Artery Aneurysm Associated with Celiac Trunk Stenosis: Case Illustration and Literature Review

Degheili

Chediak

Dergham

et al. 2017

Case Reports in Radiology

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Pancreaticoduodenal artery aneurysms (PDA) are rare visceral aneurysms. Celiac trunk stenosis represents a common attributable aetiology for those aneurysms. Therefore, an alternative treatment approach, which differs from those isolated aneurysms, is recommended. We hereby present a 77-year-old male patient who was admitted with sudden onset of severe abdominal pain and significant drop in haemoglobin, occurring within a 24-hour interval. Contrast-enhanced computed tomography revealed a ruptured visceral aneurysm arising from the anterior branch of the inferior pancreaticoduodenal artery. A severe stenosis was also noted at the take-off of the celiac trunk. Selective catheterization of the supplying branch of the superior mesenteric artery, followed by coil embolization of the aneurysm, was performed, resulting in cessation of flow within the aneurysm, with preservation of the posterior branch, supplying the celiac territory. PDAs are usually asymptomatic and discovered incidentally at rupture. The risk of rupture is independent of the aneurysmal size and is associated with a 50% mortality rate. The consensus on coping with aneurysms is to treat them whenever they are discovered. Selective angiography followed by coil embolization represents a less invasive, and frequently definitive, approach than surgery. The risk for ischemia mandates that the celiac territory must not be compromised after embolization.

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Section: Discussion and Evaluationmentioning

confidence: 99%