Sakatani A, Doi Y, Kitayama T, Matsuda T, Sasai Y, Nishida N, Sakamoto M, Uenoyama N, Kinoshita K. Pancreaticoduodenal artery aneurysm associated with coeliac artery occlusion from an aortic intramural hematoma. World J Gastroenterol 2016; 22(16): 4259-4263 [PMID: 27122676 DOI: 10.3748/wjg.v22.i16.4259]
Corresponding Author of This Article
Akihiko Sakatani, MD, Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Osaka, Japan. akihiko-sakatani@umin.net
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Akihiko Sakatani, Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Suita 565-0871, Japan
Akihiko Sakatani, Yoshinori Doi, Takaaki Matsuda, Yasutaka Sasai, Naohiro Nishida, Megumi Sakamoto, Naoto Uenoyama, Kazuo Kinoshita, Department of Gastroenterology, Otemae Hospital, Osaka 540-0008, Japan
Toshiaki Kitayama, Department of Radiology, Otemae Hospital, Osaka 540-0008, Japan
Author contributions: Sakatani A wrote the manuscript; Doi Y, Kitayama T, Matsuda T, Sasai Y, Nishida N, Sakamoto M, Uenoyama N and Kinoshita K proofread and revised the manuscript.
Institutional review board statement: Otemae Hospital Clinical Ethics Review Board does not require approval for case reports.
Informed consent statement: The patient involved in this case report authorized the disclosure of his protected health information for academic purposes.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Akihiko Sakatani, MD, Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Osaka, Japan. akihiko-sakatani@umin.net
Telephone: +81-6-68793621 Fax: +81-6-68793629
Received: December 2, 2015 Peer-review started: December 4, 2015 First decision: December 31, 2015 Revised: January 27, 2016 Accepted: February 20, 2016 Article in press: February 22, 2016 Published online: April 28, 2016
Abstract
Pancreaticoduodenal artery aneurysms are a rare type of visceral artery aneurysm, whose rupture is associated with high mortality. These aneurysms are of particular interest because local haemodynamic change caused by coeliac artery obstruction plays an important role in their development. However, the pathophysiological mechanism of coeliac artery obstruction is not completely understood. Pressure from the median arcuate ligament is most frequently reported cause. Although it is well-known that stenosis or occlusion of the visceral vessels may be caused by aortic syndrome, reports of pancreaticoduodenal artery aneurysm associated with coeliac artery occlusion due to aortic syndrome are extremely rare. Our case indicates a new aetiology for a pancreaticoduodenal artery aneurysm and demonstrates the rapid deterioration of the patient affected.
Core tip: Approximately 60% of patients with pancreaticoduodenal artery aneurysms presented with rupture have an attending mortality rate of 50%. With the development of the device and techniques, transcatheter arterial embolotherapy has decreased the mortality to as low as 0%. Therefore, early detection and treatment is necessary to improve prognosis of the case.
