The usefulness of 3d-ct for pancreatic head cancer associated with celiac and superior mesenteric artery occlusion

Abstract

A 69–year–old man found to have a tumor of the pancreatic head elsewhere was admitted to our hospital for close exploration and treatment. Abdominal CT scan showed a heterogeneously enhanced mass about 1.5cm in diameter in the pancreatic head, as well as dilatation of the pancreatic duct and calcification of the aortic wall. Three dimensional CT (3D–CT) scan showed occlusion of the proximal celiac axis and common main stem of celiac artery (CA) and superior mesenteric artery (SMA). Further the inferior mesenteric artery (IMA), marginal artery of the colon and middle colic artery developed well. We thought that blood might be supplied from the IMA to CA and SMA. We performed pylorus–preserving pancreatoduodenectomy while being careful not to injure the colic artery.
It is important to grasp the hemodynamics before pancreatoduodenectomy, for that 3D–CT scan appears to be useful.