A case of rupture of the anterior inferior pancreaticoduodenal artery aneurysm complicated with abdominal compartment syndrome

Abstract

A 59-year-old man was brought to our hospital in an ambulance complaining of abdominal pain. Abdominal contrast CT revealed retroperitoneal hematoma due to the rupture of the an anterior inferior pancreaticoduodenal artery aneurysm. It is highly possible that segmental arterial mediolysis and stenosis of the celiac trunk were associated with the aneurysm. We performed transcatheter arterial embolization for hemostasis, but the patient developed a complication of abdominal compartment syndrome due to a large retroperitoneal hematoma. After open abdominal management using mesh-mediated fascial traction with negative pressure wound therapy, we performed the removal of the retroperitoneal hematoma and definitive fascial closure. The postoperative course went well, and the patient became ambulatory and was discharged.