Open AccessInferior Pancreatico-Duodenal Artery Aneurysm with Superior Mesenteric Artery Stenosis
Author(s) -
Alin Fetti,
Vlad Radu Puia,
Mihai Comsa,
Marius Horatiu Stanca,
Aida Puia,
Nadim Al Hajjar
Publication year - 2020
Publication title -
journal of gastrointestinal and liver diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.641
H-Index - 48
eISSN - 1842-1121
pISSN - 1841-8724
DOI - 10.15403/jgld-390
Subject(s) - medicine , superior mesenteric artery , gastroduodenal artery , stenosis , radiology , duodenum , angiography , anastomosis , celiac artery , aneurysm , surgery , laparotomy , sma* , artery , mathematics , combinatorics
Pancreatico-duodenal artery aneurysm (PDAA) associated with stenosis or occlusion of the celiac trunk is a rare condition. Furthermore, PDAAs associated with stenosis of the superior mesenteric artery (SMA) are even more uncommon, with only six cases reported in the literature. We report a case of a 61-year old male patient who presented with hematemesis, haematochezia and haemorrhagic shock. The upper gastrointestinal endoscopy revealed an ulcerous lesion at the third portion of the duodenum, without achieving the haemostasis. The emergency laparotomy (suture of the lesion and gastro-entero-anastomosis) permitted temporary haemostasis. Computed tomography angiography identified the PDAA ruptured into the third portion of the duodenum and the SMA stenosis at its origin; a dense network of collateral vessels was present. The patient was successfully managed with coil embolization. Short and mid-term follow-up were without incidents.