Pseudoaneurysm of the dorsal pancreatic artery with obstruction of the celiac axis after pancreatoduodenectomy: report of a case.
Pancreatoduodenectomy can be difficult in patients with obstruction of the celiac axis because of the development of collateral arteries around the head of the pancreas. Bleeding from a pseudoaneurysm is a rare and serious complication of pancreatoduodenectomy. We report a case of a pseudoaneurysm of an enlarged dorsal pancreatic artery, which formed as a result of obstruction of the celiac axis after pancreatoduodenectomy. We assumed that a weakness in the wall of this dorsal pancreatic artery caused by the dissection led to the formation of the aneurysm. Although transcatheter arterial embolization (TAE) could not treat the aneurysm or stop bleeding from the aneurysm completely, it achieved transient hemostasis, whereby the patient's condition improved, making laparotomy safe. This case demonstrates that the dissection of arteries that have developed around the head of the pancreas must be considered in patients with obstruction of the celiac axis.
Kanazawa
Akishige
A
Department of Gastroenterological Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan.
Tanaka
Hiromu
H
Hirohashi
Kazuhiro
K
Shuto
Taichi
T
Takemura
Shigekazu
S
Tanaka
Shogo
S
Hamuro
Masao
M
Kinoshita
Hiroaki
H
Kubo
Shoji
S
D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery / Q000628:therapy; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D002445:Celiac Artery; D004621:Embolization, Therapeutic; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000098:blood supply*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*; D011859:Radiography