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

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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Visceral artery aneurysm: an unusual cause of abdominal pain

BMJ Case Reports ◽

10.1136/bcr-2020-238019 ◽

2020 ◽

Vol 13 (12) ◽

pp. e238019

Author(s):

Maha Al Baghdadi ◽

Parekha Yedla

Keyword(s):

Abdominal Pain ◽

Multiorgan Failure ◽

Artery Aneurysm ◽

Gastroduodenal Artery ◽

Visceral Artery ◽

Caucasian Woman ◽

Visceral Artery Aneurysm ◽

Visceral Artery Aneurysms

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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Splenic artery aneurysm, case series of seven patients

Journal of Surgical Case Reports ◽

10.1093/jscr/rjab046 ◽

2021 ◽

Vol 2021 (3) ◽

Author(s):

Javad Salimi ◽

Zahra Omrani ◽

Roozbeh Cheraghali

Keyword(s):

Splenic Artery ◽

Endovascular Procedures ◽

Case Series ◽

Artery Aneurysm ◽

Splenic Artery Aneurysm ◽

Visceral Artery ◽

Endovascular Techniques ◽

Hybrid Surgery ◽

First Choice ◽

Visceral Artery Aneurysms

Abstract Splenic artery aneurysms (SAA) account for 46–60% of all visceral artery aneurysms. Small SAAs are usually asymptomatic, but giant aneurysms are more likely to cause symptoms and can result in life-threatening complications. Treatment of a splenic artery aneurysms includes laparotomy, laparoscopy or endovascular techniques. Case presentation: In this article, seven interesting cases of splenic artery aneurysms in different size and parts of artery and various interventions (open, endovascular and hybrid surgery) are discussed. Six of the patients were male. Five of them had giant SAAs (≥5 cm). Two patients underwent hybrid surgery. Coil embolization was carried out for one patient. All seven patients discharged with no procedure-related complications. Endovascular procedures considered as a first choice of treatment for splenic artery aneurysm. Open surgery is reserved mostly for the treatment of complications or if the endovascular techniques fail, lack of availability of endovascular procedures or allergy to contrast medium.

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Endovascular treatment of wide-neck saccular renal artery aneurysm with waffle-cone technique

Jornal Vascular Brasileiro ◽

10.1590/1677-5449.200116 ◽

2021 ◽

Vol 20 ◽

Author(s):

Paulo Eduardo Ocke Reis ◽

Guilherme de Palma Abrão ◽

Leonardo Roever

Keyword(s):

Endovascular Procedures ◽

Imaging Techniques ◽

Artery Aneurysm ◽

Visceral Artery ◽

Endovascular Management ◽

Endovascular Techniques ◽

The Past ◽

Visceral Artery Aneurysms ◽

History Of ◽

Wide Neck

Abstract In the past, treatment of visceral artery aneurysms (VAAs) was exclusively surgical. These aneurysms were rarely diagnosed in elective or emergency cases. Development of imaging techniques and endovascular procedures has changed the history of the therapeutic options for this pathology. Endovascular management of VAAs has arisen to advances in endovascular techniques and has achieved high efficacy.

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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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Treatment of a Celiac Artery Aneurysm with Endovascular Stent Grafting

Vascular and Endovascular Surgery ◽

10.1177/153857440303700510 ◽

2003 ◽

Vol 37 (5) ◽

pp. 367-373 ◽

Cited By ~ 32

Author(s):

B. Zane Atkins ◽

J. Mark Ryan ◽

John L. Gray

Keyword(s):

Artery Aneurysm ◽

Celiac Artery ◽

Endovascular Stent ◽

Stent Grafting ◽

Endovascular Stent Grafting ◽

Celiac Artery Aneurysm

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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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