Symptomatic Pancreaticoduodenal Artery Aneurysm in patient with prior aortic surgery and Celiac Trunk obstruction: Case report

Abstract Pancreaticoduodenal artery aneurysm (PDA) is a rare visceral aneurysm and represents 1.5% of all the visceral arterial aneurysms. A 81-year old man was admitted with acute abdominal pain. He suffered 2 previous episodes of pancreatitis and he underwent abdominal aortic aneurysm repair eleven years before.The CT scan revealed a 92 mm aneurysm of inferior PDA artery with pre-rupture signs associated with the celiac trunk obstruction.The patient underwent a selective catheterization and embolization of superior PDA artery with coils, inferior PDA artery with 12 mm Amplatzer and aneurysm sac embolization by Onyx and coils.The postoperative course was uneventful and the patient was discharged on the 4th postoperative day.Celiac trunk stenosis could be one of the possible aetiology but atherosclerosis and pancreatitis are the two most common risk factors. Treatment of choice is yet to be established and it has to be properly defined "case by case"; surgery, endovascular embolization or percutaneous thrombin injection are valuable approaches.