Successful transcatheter embolization of a pancreaticoduodenal artery aneurysm in association with celiac axis occlusion: A case report

We report a case of a pancreaticoduodenal artery (PDA) aneurysm in associat ion with celiac axis occlusion. A 54 year-old female complaining of abrupt onset of abdominal pain was admitted to our hospital. On admission, abdomin al CT examination revealed a hematoma in the retroperitoneal space. Selecti ve superior mesenteric artery (SMA) angiography disclosed an aneurysm in th e anterior inferior pancreaticoduodenal artery (AIPDA). The celiac axis was occluded and blood was flowing to the liver and spleen via the enlarged pa ncreaticoduodenal arcade from the SMA. Transcatheter embolization of the an eurysm was performed successfully. Up to 1996, there have been 37 reported cases of PDA aneurysm in association with celiac axis stenosis or occlusion , including this one. Transcatheter embolization was performed successfully in only 5 of these cases. The formation of this type of PDA aneurysm is th ought to be a result of the increased blood flow in the pancreaticoduodenal arcade due to celiac axis stenosis or occlusion. The transcatheter emboliz ation performed in our report produced a far greater blood flow, which may lead to further aneurysmal formation. Careful follow-up is therefore necess ary.