Visceral artery aneurysm: an unusual cause of abdominal pain

Visceral artery aneurysms (VAAs) are uncommon with an approximate incidence of 0.01%–0.2%. Gastroduodenal artery (GDA) aneurysm is a rare subtype of these uncommon visceral aneurysms that can be fatal if ruptured. We present a case of a 58-year-old Caucasian woman with a VAA and a large haematoma arising from an actively bleeding GDA. While patients with VAA may remain asymptomatic, with some of the aneurysms found incidentally during imaging, they may also present with abdominal pain, anaemia and possible multiorgan failure which may be fatal.

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Visceral Artery Aneurysms: A Symptomatic Aneurysm of the Ileocolic Artery

Vascular ◽

10.2310/6670.2007.00020 ◽

2007 ◽

Vol 15 (3) ◽

pp. 162-166

Author(s):

Graham Roche-Nagle ◽

David O'Donnell ◽

Timothy O'Hanrahan

Keyword(s):

Mortality Rate ◽

Incidental Findings ◽

Artery Aneurysm ◽

Vascular Pathology ◽

Visceral Artery ◽

Visceral Artery Aneurysm ◽

Ileocolic Artery ◽

Visceral Artery Aneurysms ◽

Therapeutic Procedures ◽

Important Form

Visceral artery aneurysm is a rare but clinically important form of vascular pathology, showing a high mortality rate in emergency surgery. Most often these aneurysms cause no symptoms and are therefore incidental findings. Reports on ileocolic artery aneurysms are rare and often anecdotal. Therapeutic procedures can be performed either surgically or by interventional therapeutic techniques. This article presents a case of ruptured ileocolic artery aneurysm and reviews the literature on this topic.

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Endovascular Aneurysm Management of a Gastroduodenal Artery Aneurysm in a Multipara Pregnant Woman

Vascular and Endovascular Surgery ◽

10.1177/1538574412444010 ◽

2012 ◽

Vol 46 (5) ◽

pp. 422-426 ◽

Cited By ~ 2

Author(s):

Gerd Grözinger ◽

Martin Heuschmid ◽

Klaus Herz ◽

Bernd Balletshofer ◽

Dominik Ketelsen ◽

...

Keyword(s):

Pregnant Woman ◽

Endovascular Therapy ◽

Scattered Radiation ◽

Critical Level ◽

Artery Aneurysm ◽

Gastroduodenal Artery ◽

Visceral Artery ◽

Visceral Artery Aneurysm ◽

Gastroduodenal Artery Aneurysm ◽

First Time

The authors describe a case of an intrapancreatic gastroduodenal artery aneurysm in a pregnant woman. Successful endovascular therapy was performed for the first time in a visceral artery aneurysm during pregnancy as a bailout solution. The attributive risk to the fetus from scattered radiation during endovascular treatment did not exceed a critical level.

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Concurrent Treatment of Acute Pancreatitis and Multiple Visceral Artery Aneurysms Using Endovascular Techniques

Vascular and Endovascular Surgery ◽

10.1177/1538574412440509 ◽

2012 ◽

Vol 46 (3) ◽

pp. 283-286 ◽

Cited By ~ 1

Author(s):

Mario Mitkov ◽

Weesam Kassim Al-Khatib ◽

Wei Zhou

Keyword(s):

Acute Pancreatitis ◽

Surgical Techniques ◽

Artery Aneurysm ◽

Celiac Artery ◽

Gastroduodenal Artery ◽

Visceral Artery ◽

Endovascular Techniques ◽

Concurrent Treatment ◽

Visceral Artery Aneurysms ◽

Celiac Artery Aneurysm

Multiple aneurysms involving the celiac axis are extremely rare. Celiac artery aneurysms account for only 4% of all visceral aneurysms with 40% having concomitant aneurysms such as gastroduodenal artery (GDA) aneurysms. Development of a GDA aneurysm is associated with pancreatitis. If a GDA aneurysm ruptures, traditional repair is through open surgical techniques with significant morbidity and mortality as up to 50% occur in the setting of chronic pancreatitis. However, a ruptured GDA aneurysm causing pancreatitis has not been described previously. We report a case of successful endovascular treatment of a ruptured GDA aneurysm and concomitant celiac artery aneurysm leading to the resolution of acute pancreatitis.

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P-P56 Successful endovascular embolisation of a recurrent gastroduodenal artery aneurysm in a patient presenting with acute on chronic pancreatitis

British Journal of Surgery ◽

10.1093/bjs/znab430.278 ◽

2021 ◽

Vol 108 (Supplement_9) ◽

Author(s):

Dheepa Nair ◽

Katie Jones ◽

Rajeev Parameswaran

Keyword(s):

Chronic Pancreatitis ◽

Epigastric Pain ◽

Contrast Material ◽

Pancreatic Head ◽

Artery Aneurysm ◽

Gastroduodenal Artery ◽

Visceral Artery ◽

Pseudoaneurysm Formation ◽

Visceral Artery Aneurysms ◽

History Of

Abstract Background Pseudoaneurysms are recognised to be a serious complication of chronic pancreatitis. Visceral artery aneurysms (VAA) can be difficult to determine and most commonly occur in the splenic or hepatic artery. Gastroduodenal artery pseudoaneurysms (GDA) have been reported to be the most common VAA following pancreatic surgery. We aim to outline the successful management of a patient with a recurrent 5.5cm GDA pseudoaneurysm following previous embolisation 2 years prior. Methods The 59yr old patient had a history of alcohol related necrotic pancreatitis with pseudocyst formation requiring percutaneous drainage in 2019. This was complicated by pseudoaneurysm formation requiring embolisation of the inferior pancreatico-duodenal artery and GDA. In April 2021 they were readmitted with recurrent abdominal pain thought to be secondary to chronic pancreatitis and one episode of haematemesis. Results Endoscopy revealed inflammation of D1 with signs of recent mucosal bleeding with a recent abdominal ultrasound showing a 4.7x4.6cm apparent pseudocyst. A CT pancreas was performed to assess the pseudocyst however an incidental pseudoaneurysm at the pancreatic head with a sac measuring 5.5cm in diameter and contrast material measuring 3cm in diameter was present. Peripancreatic and retroperitoneal inflammation indicative of acute on chronic pancreatitis. The patient underwent embolisation of the recurrent GDA pseudoaneurysm successfully with no more filling of the previously seen pseudoaneurysm and was safely discharged. Conclusions Recurrent GDA pseudoaneurysms are a very rare complication of recurrent pancreatitis, however should be considered in patients presenting severe epigastric pain with a history of previous pseudoaneurysms.

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Association of statins with aortic, peripheral, and visceral artery aneurysm development

Vascular ◽

10.1177/1708538116684942 ◽

2016 ◽

Vol 25 (4) ◽

pp. 372-381 ◽

Cited By ~ 2

Author(s):

Ishak A Mansi ◽

Christopher R Frei ◽

Ethan A Halm ◽

Eric M Mortensen

Keyword(s):

Aortic Aneurysm ◽

Secondary Analysis ◽

Artery Aneurysm ◽

Visceral Artery ◽

Arterial Aneurysm ◽

Visceral Artery Aneurysm ◽

Visceral Artery Aneurysms ◽

Aneurysm Development ◽

Aneurysm Repair ◽

Aortic Aneurysm Repair

Objectives Prior studies examining the effects of statins on arterial aneurysm development and progression yielded conflicting results due to their smaller size and presence of residual confounders. The objective of this study is to examine the association of statins with risk of being diagnosed with aortic, peripheral, and visceral artery aneurysm. Methods This was a retrospective cohort study of Tricare enrollees (from 1 October 2003 to 31 March 2012). Main outcomes were diagnosis of aortic, peripheral, or visceral artery aneurysm and undergoing aortic aneurysm repair procedure during follow-up period. Using 115 baseline characteristics, we generated a propensity score to match statin users and nonusers and examine the odds of outcomes (primary analysis). Secondary analysis examined outcomes at various subcohorts. Results Out of 10,910 statin users and 49,545 nonusers, we propensity score-matched 6728 pairs of statin users and nonusers. Statin users and nonusers had similar odds of being diagnosed with aortic, peripheral, and visceral artery aneurysms (odds ratio [OR]: 1.06, 95% confidence interval [95% CI]: 0.85–1.33) and of undergoing aortic aneurysm repair procedures (OR: 0.54, 95% CI: 0.22–1.35). Secondary analysis showed a tendency toward fewer aortic aneurysm procedures among statin users that did not reach statistical significance. However, high-intensity statin users in comparison to non-intensive statin users had higher adjusted odds of aortic, peripheral, and visceral artery aneurysms (OR: 1.76, 95% CI: 1.37–2.25, p < .0001). Conclusions This study does not support a clinically significant benefit or harm from statins regarding development of arterial aneurysm. However, secondary analyses may support the hypothesis proposed by previous research proposing a bidirectional role for statins.

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Splenic and hepatic artery aneurysm: a case report

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20214073 ◽

2021 ◽

Author(s):

Raúl Andrés Troya Malo ◽

Luis Ernesto Suárez Luna ◽

Gloria Barrera Gómez ◽

Karina Sánchez Reyes

Keyword(s):

Abdominal Pain ◽

Open Surgery ◽

Rare Case ◽

Incidental Finding ◽

Specific Treatment ◽

Artery Aneurysm ◽

Visceral Artery ◽

Imaging Studies ◽

Hepatic Artery Aneurysm ◽

Visceral Artery Aneurysms

Visceral artery aneurysms (VAA) have an incidence of 0.01-2% and are mainly diagnosed as an incidental finding in imaging studies done for other reasons. Their mortality when ruptured can be as high has 75%. We present a rare case of multiple visceral artery aneurysms that presented as dull abdominal pain and were managed with open surgery in accordance to specific treatment criteria.

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The Aftermath of a Hepatic Artery Aneurysm—A Rare Etiology of Biliary Obstruction!

Clinical Medicine Insights Gastroenterology ◽

10.1177/1179552217711430 ◽

2017 ◽

Vol 10 ◽

pp. 117955221771143 ◽

Cited By ~ 1

Author(s):

Catherine Linzay ◽

Abhishek Seth ◽

Kunal Suryawala ◽

Ankur Sheth ◽

Moheb Boktor ◽

...

Keyword(s):

Obstructive Jaundice ◽

Hepatic Artery ◽

Significant Risk ◽

Artery Aneurysm ◽

Biliary Tree ◽

Visceral Artery ◽

Biliary Stenting ◽

Hepatic Artery Aneurysm ◽

Skin Imaging ◽

Visceral Artery Aneurysms

Background: Hepatic artery aneurysms (HAAs) constitute 14% to 20% of visceral artery aneurysms. Most HAAs are asymptomatic. Although rare, obstructive jaundice due to external bile duct compression or rupture of the HAA into the biliary tree with occlusion of the lumen from blood clots has been reported. Case presentation: A 56-year-old white man presented to an outside hospital with symptoms of obstructive jaundice, including abdominal pain and yellowing of the skin. Imaging showed a large HAA. Patient was transferred to our hospital where an endoscopic retrograde cholangiopancreatography with biliary stenting was performed. This was followed by coil embolization of the HAA with improvement in symptoms and liver chemistries. Conclusions: Most clinicians agree that management of HAA is highly variable and depends on clinical presentation and anatomic location. Biliary stenting provides temporary relief for patients with obstructive jaundice. Definitive options include open aneurysmal repair versus endovascular therapy. Hepatic artery aneurysms represent a significant risk for hemorrhage and therefore must be addressed promptly once discovered.

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