BACKGROUND: True aneurysms of the pancreaticoduodenal arteries (PDA) are rare, often ruptured, and treated by operation with a high level of mortality. We review our experience since 1994 and that of the literature in the past 20 years to provide management guidelines for this uncommon clinical entity. About 100 cases of PDA aneurysms are described in the literature, most of them as case report. METHODS: Nine patients were admitted to our institution between 1994 and 2004 for true aneurysm of the PDA. They were analyzed with regard to the clinical presentation, radiologic findings, management, and outcome. RESULTS: Seven patients presented for sudden abdominal pain from retroperitoneal hemorrhage. In 2 patients PDA aneurysm was an incidental finding. Abdominal ultrasonography, computed tomographic scan, and visceral angiography was carried out in all cases. Aneurysms ranged from 4 to 30 mm (median, 16.5) in size. Celiac axis stenosis or occlusion was identified in 3 patients. One patient required emergent laparotomy for intra-abdominal rupture of a retro peritoneal hematoma. Therapeutic embolization was successful in all 9 patients. All except 1 are alive with no evidence of recurrence of the true PDA aneurysm with a mean follow-up of 59 months. CONCLUSIONS: The authors recommend definitive treatment of all true aneurysms PDA because of their high risk of rupture. Ruptured PDA aneurysms suspected on CT-scan requires emergent visceral angiography and selective embolization as definitive treatment.
BACKGROUND: True aneurysms of the pancreaticoduodenal arteries (PDA) are rare, often ruptured, and treated by operation with a high level of mortality. We review our experience since 1994 and that of the literature in the past 20 years to provide management guidelines for this uncommon clinical entity. About 100 cases of PDAaneurysms are described in the literature, most of them as case report. METHODS: Nine patients were admitted to our institution between 1994 and 2004 for true aneurysm of the PDA. They were analyzed with regard to the clinical presentation, radiologic findings, management, and outcome. RESULTS: Seven patients presented for sudden abdominal pain from retroperitoneal hemorrhage. In 2 patientsPDAaneurysm was an incidental finding. Abdominal ultrasonography, computed tomographic scan, and visceral angiography was carried out in all cases. Aneurysms ranged from 4 to 30 mm (median, 16.5) in size. Celiac axis stenosis or occlusion was identified in 3 patients. One patient required emergent laparotomy for intra-abdominal rupture of a retro peritoneal hematoma. Therapeutic embolization was successful in all 9 patients. All except 1 are alive with no evidence of recurrence of the true PDAaneurysm with a mean follow-up of 59 months. CONCLUSIONS: The authors recommend definitive treatment of all true aneurysmsPDA because of their high risk of rupture. Ruptured PDAaneurysms suspected on CT-scan requires emergent visceral angiography and selective embolization as definitive treatment.
Authors: S K Kamarajah; S Kharkhanis; M Duddy; J Isaac; R P Sutcliffe; H Mehrzad; Bvm Dasari Journal: Ann R Coll Surg Engl Date: 2019-03-11 Impact factor: 1.891
Authors: Carola Rubio Taboada; Jesús García Alonso; Rubén Peña Cortés; Luis Velasco Pelayo; Paula Velasco Hernández; Francisco Santiago Lozano Sánchez Journal: J Vasc Bras Date: 2020-08-31