title: Surgical treatment of celiac-splenic aneurysms without arterial reconstruction.
abstract: We report a case of multiple sequential celiacsplenic aneurysms which we removed completely without arterial reconstruction. The patient was a 67-year-old man. During work-up for hypertension and diabetes, a splenic artery aneurysm was identified on abdominal ultrasonography. Follow-up examination 1 year and 3 months later showed enlargement of the aneurysm. The patient was referred to our Radiology Department for treatment. Abdominal computed tomography and angiography of the celiac trunk showed that the celiac artery was narrowed and then dilated to form a fusiform aneurysm. Splenic artery aneurysms were identified immediately distal to the bifurcation with the common hepatic artery, measuring about 5 cm and 3 cm. These findings ruled out treatment by interventional radiology, and surgery was performed. At laparotomy, a white, 5-cm aneurysm was densely adherent to the pancreas, and separation was impossible. We performed en bloc resection of the pancreatic body and tail, spleen, celiac artery, and common hepatic artery. Since pulsation in the replaced right hepatic artery and the color of the stomach were good, we did not perform an arterial reconstruction. Although the surgical treatment of aneurysms generally consists of resection and arterial reconstruction, we resected the lesion safely and completely without arterial reconstruction.
authors.affiliation: Department of Surgical Oncology, Hokkaido University Graduate School of Medicine Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan. mkado.6809@kib.biglobe.ne.jp
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kadoya
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kondo
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hirano
authors.forename: Yoshiyasu
authors.initials: Y
authors.lastname: Ambo
authors.forename: Eiichi
authors.initials: E
authors.lastname: Tanaka
authors.forename: Norihiro
authors.initials: N
authors.lastname: Takemoto
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Morikawa
authors.forename: Shunichi
authors.initials: S
authors.lastname: Okushiba
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Katoh
mesh_terms: D000368:Aged; D000783:Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D002445:Celiac Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D011859:Radiography; D013157:Splenic Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures