Successful transcatheter embolization of a pancreaticoduodenal artery aneurysm in association with celiac axis occlusion: a case report.

We report a case of a pancreaticoduodenal artery (PDA) aneurysm in association with celiac axis occlusion. A 54 year-old female complaining of abrupt onset of abdominal pain was admitted to our hospital. On admission, abdominal CT examination revealed a hematoma in the retroperitoneal space. Selective superior mesenteric artery (SMA) angiography disclosed an aneurysm in the anterior inferior pancreaticoduodenal artery (AIPDA). The celiac axis was occluded and blood was flowing to the liver and spleen via the enlarged pancreaticoduodenal arcade from the SMA. Transcatheter embolization of the aneurysm was performed successfully. Up to 1996, there have been 37 reported cases of PDA aneurysm in association with celiac axis stenosis or occlusion, including this one. Transcatheter embolization was performed successfully in only 5 of these cases. The formation of this type of PDA aneurysm is thought to be a result of the increased blood flow in the pancreaticoduodenal arcade due to celiac axis stenosis or occlusion. The transcatheter embolization performed in our report produced a far greater blood flow, which may lead to further aneurysmal formation. Careful follow-up is therefore necessary.