Aorto-gastroduodenal bypass grafting for an inferior pancreaticoduodenal aneurysm and celiac trunk thrombosis.
We present a case of a male patient diagnosed with a large inferior pancreaticoduodenal artery (IPDA) aneurysm, associated with a fresh thrombotic occlusion of the celiac trunk. Given the risk of splanchnic ischaemia, radiologic embolisation of the aneurysm combined with celiac axis stenting was deemed unsafe. Management was therefore modified to elective revascularisation of the celiac axis prior to surgical resection of the aneurysm. A retropancreatic aorto-gastroduodenal artery bypass graft was performed prior to exposing and resecting the pancreaticoduodenal artery aneurysm. This ensured near uninterrupted retrograde supply to the celiac axis during the procedure. This is an effective, efficient and expeditious patient pathway for these rare and complex aneurysms complicated by celiac trunk involvement.
Ritter
Jens C
JC
University of South Manchester, Southmoor Rd, Wythenshawe, Manchester, M23 9LT, UK. jc.ritter@web.de
Johnston
Malcolm
M
Caruana
Mario F
MF
Laws
Peter E
PE
D000783:Aneurysm / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001011:Aorta / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D002445:Celiac Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D003251:Constriction, Pathologic; D004386:Duodenum / Q000098:blood supply*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000098:blood supply*; D013927:Thrombosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome