Naoko Fukushima1, Hiroaki Aoki2, Shinsuke Takenaga3, Kazuhiko Morikawa3, Masaichi Ogawa2, Katsuhiko Yanaga4. 1. Department of Surgery, Katsushika Medical Center, The Jikei University, School of Medicine, 6-41-2 Aoto, Katsushikaku, Tokyo, 125-8506, Japan. naoko9037@gmail.com. 2. Department of Surgery, Katsushika Medical Center, The Jikei University, School of Medicine, 6-41-2 Aoto, Katsushikaku, Tokyo, 125-8506, Japan. 3. Department of Radiology, Katsushika Medical Center, The Jikei University, School of Medicine, 6-41-2 Aoto, Katsushikaku, Tokyo, 125-8506, Japan. 4. Department of Surgery, The Jikei University, School of Medicine, 3-19-18 Nishishinbashi, Minatoku, Tokyo, 105-8471, Japan.
Abstract
BACKGROUND: Neurofibromatosis type 1 (NF-1) is an autosomal dominant disease and arteriovenous abnormalities are a well-recognized complication. There are several case reports of ruptured aneurysms; however, among them, reports of superior pancreaticoduodenal artery (PDA) and superior mesenteric artery (SMA) aneurysms are rare. We experienced the case of ruptured PDA and SMA aneurysms in a patient of neurofibromatosis type I successfully treated by endovascular treatment. CASE PRESENTATION: A 55-year-old woman with NF-1 came to our hospital with abdominal pain and vomiting. Enhanced abdominal computed tomography revealed a hematoma in the retroperitoneum and an aneurysm in the head of the pancreas. Angiography was performed, and a ruptured aneurysm was suspected the periphery of the PDA, and we embolized it using coils. However, on postoperative day 2, the hemoglobin level decreased, and a branch of the SMA was ruptured. She underwent embolization using coils again and discharged on postoperative day 27 without any further hemorrhage. CONCLUSIONS: To our knowledge, this is the first successfully treated case of ruptured SMA and PDA aneurysms in a patient with NF-1.
BACKGROUND:Neurofibromatosis type 1 (NF-1) is an autosomal dominant disease and arteriovenous abnormalities are a well-recognized complication. There are several case reports of ruptured aneurysms; however, among them, reports of superior pancreaticoduodenal artery (PDA) and superior mesenteric artery (SMA) aneurysms are rare. We experienced the case of ruptured PDA and SMA aneurysms in a patient of neurofibromatosis type I successfully treated by endovascular treatment. CASE PRESENTATION: A 55-year-old woman with NF-1 came to our hospital with abdominal pain and vomiting. Enhanced abdominal computed tomography revealed a hematoma in the retroperitoneum and an aneurysm in the head of the pancreas. Angiography was performed, and a ruptured aneurysm was suspected the periphery of the PDA, and we embolized it using coils. However, on postoperative day 2, the hemoglobin level decreased, and a branch of the SMA was ruptured. She underwent embolization using coils again and discharged on postoperative day 27 without any further hemorrhage. CONCLUSIONS: To our knowledge, this is the first successfully treated case of ruptured SMA and PDA aneurysms in a patient with NF-1.
Entities:
Keywords:
Endovascular treatment; Neurofibromatosis type 1; Visceral artery aneurysms