Bleeding gastric varices as a result of splenic vein compression by a celiac arterial aneurysm.
Celiac arterial aneurysms are very unusual and often lack clinical manifestations. According to our review of the literature, this is the first report of a patient with a large celiac arterial aneurysm who exhibited hematemesis from gastric varices. Arteriography, as well as color Doppler ultrasonography and enhanced computed tomography, contributed to the diagnosis of this aneurysm, which was best exposed by a left thoracoabdominal approach. In this patient the lesion was a false aneurysm with perforation of the celiac artery, so simple closure of the orifice was carried out and the revascularization of the celiac artery was not necessary, but we should take care not to ignore the possible recurrence of vascular lesions. The risk of celiac arterial aneurysm rupture is relatively high, but the operative mortality of unruptured aneurysms is now so low that operation is strongly recommended for all patients with this type of aneurysm.
Kimura
H
H
Second Department of Surgery, Faculty of Medicine, University of Tokyo, Japan.
Sato
O
O
Miyata
T
T
Koyama
H
H
Sugawara
Y
Y
Takagi
A
A
D000783:Aneurysm / Q000150:complications*; D002445:Celiac Artery; D004932:Esophageal and Gastric Varices / Q000209:etiology*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013162:Splenic Vein