Abstract
We report a pancreaticoduodenal arterial aneurysm probably formed by hemodynamic stress compasating for stenosis of the celiac axis.
A 48-year-old woman with epigastralgia was found to have an inferior pancreaticoduodenal arterial aneurysm 3cm in diameter. Arteriography showed retrograde blood flow in the common hepatic artery, suggesting an increase in blood flow through the superior mesenteric artery. She underwent an operation in which we released a compression by cutting the median arcuate ligament following an aneurysmectomy. Three months later, an arteriography revealed an improvement of the celiac arterial stenosis and antegrade blood flow in the common hepatic artery. A pancreaticoduodenal arterial aneurysm associated with celiac arterial stenosis is relatively rare but rupture cases have been reported. Decompression of the celiac axis and aneurysmectomy should be performed electively in order to avoid disastrous rupture.
