| Ruptured Pancreaticoduodenal
Artery Aneurysm |
(Division of Vascular Surgery, Department of Surgery
(E2), Osaka University Graduate School of Medicine, Suita, Japan
and Division of Vascular Surgery, Higashi Takarazuka Satoh Hospital*,
Takarazuka, Japan)
| Takashi Shibuya* |
Tomio Kawasaki |
|
|
A 59-year-old man was admitted with
sudden onset of back pain and abdominal discomfort. There was
no history of pancreatitis, abdominal injury, or abdominal surgery.
Enhanced abdominal computed tomography (CT) showed retroperitoneal
hematoma behind the head of the pancreas, and emergency angiography
demonstrated retroperitoneal bleeding due to rupture of a superior
pancreaticoduodenal artery aneurysm. Embolization was tried unsuccessfully,
because of difficulty in selective cannulation of the vessel
feeding the aneurysm. Emergency laparotomy was performed. We
inserted a finger behind the pancreas via the lateral side of
the duodenum by Kocher's maneuver, then ligated the ruptured
portion of the superior pancreaticoduodenal artery. We did not
reconstruct the artery because blood supply to the peripheral
tissue was good. The patient's postoperative course was uneventful,
and he was discharged from the hospital in good condition 1 month
after surgery. CT proved to be useful in revealing the voluminous
retroperitoneal hematoma, and angiography proved to be necessary
for the definitive diagnosis of pancreaticoduodenal artery aneurysm.
Jpn. J. Cardiovasc. Surg. 32: 343 -346 (2003) |
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