Celiac artery aneurysms: historic (1745-1949) versus contemporary (1950-1984) differences in etiology and clinical importance.

Celiac artery aneurysms were encountered in nine patients, ranging in age from 39 to 76 years, at the University of Michigan Medical Center between 1961 and 1983. Developmental defects and atherosclerosis were etiologic factors in six cases. Four patients were without symptoms, whereas five experienced abdominal pain, including one with a ruptured aneurysm. Eight patients were subjected to surgical treatment; no deaths occurred and symptoms were resolved in all patients. A literature review of 108 celiac artery aneurysms revealed two distinct subgroups. Among 60 celiac artery aneurysms encountered before 1950, representing the historic era, 40% were infectious (usually luetic), 7% were traumatic, and 52% were of undetermined cause. Most were symptomatic, 87% ruptured, and 95% were diagnosed at postmortem examination. The contemporary era since 1950 consisted of 48 cases, including nine in the Michigan experience. Congenital or developmental medial defects of the arterial wall and atherosclerosis were the most common causes of aneurysms. Most aneurysms in the contemporary period were either asymptomatic or accompanied by vague abdominal discomfort. Rupture affected 13% of those aneurysms. Operative therapy was successfully undertaken in 91% of 43 patients during the contemporary era, including eight in the present series.