ANEURYSMS OF THE PANCREATICODUODENAL ARTERIES - A CHANGE IN MANAGEMENT

Since the first report of an aneurysm involving the pancreaticoduodena l arteries a century ago, only 83 cases have been reported in our coll ective review of the English literature. Their presentation varies fro m indistinct abdominal pain to hemorrhagic shock, often making the dia gnosis onerous. The mortality rate in this patient group has been sign ificant, and in cases reported since 1980, the mortality rate remains at 17% (7 deaths/42 reported cases). Surgery has been, and continues t o be, the cornerstone of therapy, with an incumbent mortality rate of 19% (5 deaths/26 patients treated surgically since 1980). This case re port and 100-year review of the literature describes the causes, natur al history, and historic management of pancreaticoduodenal artery aneu rysms. Most importantly, it demonstrates the use of angiographic embol ization in the definitive management of these aneurysms with no mortal ity.