title: Obstructive jaundice caused by pancreaticoduodenal artery aneurysms associated with celiac axis stenosis: case report and review of the literature.
abstract: Pancreaticoduodenal artery aneurysm (PDA) is quite rare, which accounts for only approximate 2% of all visceral aneurysms. Besides, PDA is usually related to celiac axis stenosis (CAS) and prone to rupture. Advanced imaging examination can facilitate the disclosure of such peripancreatic masses, but most of them were seldom diagnosed until they rupture because of the nonspecific symptoms. Secondary to PDA, obstructive jaundice is however an extremely rare manifestation. A case of an 84-year-old man is reported here, who suffered from severe jaundice caused by a ruptured PDA associated with CAS. In addition, this review collects and organizes PDAs with jaundice by applying a MEDLINE search and discusses the pathogenesis and therapeutic options of these aneurysms leading to external compression over the bile duct. Consequently, the formation of PDA with obstructive jaundice is based on the specific anatomy of pancreaticoduodenal arcades. When there is a retroperitoneal mass around the head of the pancreas associated with unexpected jaundice, PDA should be considered, for which early aggressive therapy is required. The case report and literature review suggest that PDA associated with obstructive jaundice may be treated successfully by single transcatheter arterial embolization (TAE) without auxiliary biliary drainage, whether it ruptures or not.
authors.affiliation: Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Tiansheng
authors.initials: T
authors.lastname: Yin
authors.affiliation: Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Zhili
authors.initials: Z
authors.lastname: Wan
authors.affiliation: Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Hongwei
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Xixian
authors.initials: X
authors.lastname: Mao
authors.affiliation: Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Yayang
authors.initials: Y
authors.lastname: Yi
authors.affiliation: Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China. Electronic address: lidewei406@sina.com.
authors.forename: Dewei
authors.initials: D
authors.lastname: Li
mesh_terms: D000369:Aged, 80 and over; D000783:Aneurysm / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D000792:Angiography; D001157:Arterial Occlusive Diseases / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D002445:Celiac Artery; D004386:Duodenum / Q000098:blood supply*; D057510:Endovascular Procedures / Q000379:methods*; D017809:Fatal Outcome; D006801:Humans; D041781:Jaundice, Obstructive / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D010179:Pancreas / Q000098:blood supply*; D014057:Tomography, X-Ray Computed