A ruptured pancreaticoduodenal artery aneurysm associated with a splenic artery aneurysm: Report of a case

True pancreaticoduodenal artery (PDA) aneurysms are extremely rare. We repo rt herein a case of a ruptured PDA aneurysm associated with a nonruptured s plenic artery aneurysm which was successfully treated by surgery. A 55-year -old man was admitted to a local hospital complaining of sudden abdominal a nd back pain, and thereafter he was transferred to our university hospital. Abdominal computed tomography revealed retroperitoneal hematoma and an enh anced round spot suggesting a peripancreatic aneurysm. Emergency angiograph y showed a 20-mm-sized aneurysm in the inferior PDA and a 10-mm-sized aneur ysm in the splenic artery. The patient underwent an emergency laparotomy wi th a diagnosis of a ruptured PDA aneurysm. After evacuating a large volume clot in the right retroperitoneal space and the peritoneal cavity, we detec ted an index finger-sized aneurysm with arterial bleeding in the right infe rioposterior aspect of the pancreas. Hemostasis was obtained by oversewing the aneurysm and a ligation of the feeding arteries. A prophylactic splenec tomy was performed for the nonruptured splenic artery aneurysm. This case i ndicates that emergency angiography is indispensable for both a definitive diagnosis and adequate surgical treatment of PDA aneurysms.