Abstract
A 62-years-old woman had abdominal pain of unknown origin. Examinations showed a 19-mm saccular type inferior pancreaticoduodenal arterial (IPDA) aneurysm and dilatation in the posterior branch of IPDA, and also severe stenosis in the celiac axis. Selective superior mesenteric angiography showed dilatation and tortuosity of the IPDA with retrograde filling of the the celiac artery as a good collateral pathway. Increased blood flow may be an important etiologic factor for IPDA aneurysm and dilatation in its posterior branch. To reduce the risk of perioperative ischemia of the abdominal organs and prevent progression of collateral circulation, abdominal aortic common hepatic artery bypass with a reversed vein graft was done, and the IPDA aneurysm was resected. The intraoperative bypass blood flow rate was 500 ml/min. The postoperative course was uneventful. A 3-dimensional computed tomographic scan 1 year after operation showed the patency of the abdominal aorta-common hepatic artery bypass and no recurrence of the PDA aneurysm. We believe that resection of the IPDA aneurysm with aortohepatic artery bypass is a useful method for treatment of IPDA aneurysms with stenotic or occluded celiac axis.
