202 results on '"Inferior pancreaticoduodenal artery"'
Search Results
2. Compression of the Distal Common Bile Duct by Enlarged Inferior Pancreaticoduodenal Artery Branches in a Patient with Celiac Trunk Stenosis: A Case Report
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Anıl Çolaklar, Diğdem Kuru Öz, and Ayşe Erden
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common bile duct ,compression ,inferior pancreaticoduodenal artery ,magnetic cholangiopancreatography ,Internal medicine ,RC31-1245 ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Various benign and malignant pathologies/conditions can cause compression of the extrahepatic biliary system. Anatomical and/or topographic variations of the hepatic artery have long been recognized as a possible cause of the EBS compression. However, anatomical and/or topographic variations, other than the hepatic artery's, should also be considered during the evaluation of the EBS compression. We, herein, report a unique case of the distal common bile duct compression by tortuous and enlarged inferior pancreaticoduodenal artery branches due to severe stenosis of the celiac trunk orifice.
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- 2023
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3. Modified Distal Pancreatectomy with Celiac Axis En-bloc Resection
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Okada, Ken-ichi, Yamaue, Hiroki, Makuuchi, Masatoshi, editor, Kokudo, Norihiro, editor, Popescu, Irinel, editor, Belghiti, Jacques, editor, Han, Ho-Seong, editor, Takaori, Kyoichi, editor, and Duda, Dan G., editor
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- 2022
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4. Compression of the Distal Common Bile Duct by Enlarged Inferior Pancreaticoduodenal Artery Branches in a Patient with Celiac Trunk Stenosis: A Case Report.
- Author
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Çolaklar, Anıl, Kuru Öz, Diğdem, and Erden, Ayşe
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HEPATIC artery ,ARTERIAL occlusions ,LIVER function tests ,ENDOSCOPIC retrograde cholangiopancreatography ,CELIAC artery ,BILE ducts ,COMPUTED tomography ,DISEASE complications - Abstract
Various benign and malignant pathologies/conditions can cause compression of the extrahepatic biliary system. Anatomical and/or topographic variations of the hepatic artery have long been recognized as a possible cause of the EBS compression. However, anatomical and/or topographic variations, other than the hepatic artery's, should also be considered during the evaluation of the EBS compression. We, herein, report a unique case of the distal common bile duct compression by tortuous and enlarged inferior pancreaticoduodenal artery branches due to severe stenosis of the celiac trunk orifice. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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- View/download PDF
5. Acute pancreatitis complicated with peripancreatic pseudoaneurysm and subsequent intra‐abdominal hematoma
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Hsueh‐Chien Chiang, Yi‐Ning Lo, Chiung‐Yu Chen, Chiao‐Hsiung Chuang, Tzu‐Chun Hong, and Hsin‐Yu Kuo
- Subjects
acute pancreatitis ,inferior pancreaticoduodenal artery ,intra‐abdominal hematoma ,peripancreatic pseudoaneurysm ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Published
- 2023
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6. Gastroduodenal artery pseudoaneursym in Carcinoma Pancreas post SBRT.
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Suneetha N, Poojari M, Pratheema S, Vidya B, Indushekhar S, Swamy S, and Belliappa MS
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- 2024
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7. Duodenal stenosis after transcatheter arterial embolization for rupture of an inferior pancreaticoduodenal aneurysm
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Keita Nakayama, MD, Masashi Shimohira, MD, Keiichi Nagai, MD, Kengo Ohta, MD, Tatsuya Kawai, MD, Yusuke Sawada, MD, Shunsuke Shibata, MD, and Yuta Shibamoto, MD
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Inferior pancreaticoduodenal artery ,Aneurysm ,Embolization ,Complication ,Duodenal stenosis ,Medical physics. Medical radiology. Nuclear medicine ,R895-920 - Abstract
A 64-year-old man presented with epigastric pain and underwent contrast-enhanced computed tomography. Ruptured aneurysm of the inferior pancreaticoduodenal artery was diagnosed. TAE was successfully accomplished using coils, but vomiting appeared 9 days later. Duodenal stenosis was diagnosed from contrast-enhanced computed tomography and upper gastrointestinal endoscopy and was attributed to edematous changes in the duodenum. Conservative management led to successful recovery and discharge.
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- 2021
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8. Study Data from Medical Faculty and University Hospital Dusseldorf Update Understanding of Aneurysm (A Two Stage Open and Interventional Therapeutic Approach for an Inferior Pancreaticoduodenal Artery Aneurysm With Coeliac Artery Occlusion).
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CELIAC artery ,ARTERIAL diseases ,HEPATIC artery ,MESENTERIC artery ,ARTERIAL occlusions - Abstract
A study conducted by researchers at the Medical Faculty and University Hospital Dusseldorf provides new insights into the treatment of aneurysms. The study focuses on a case involving a patient with an inferior pancreaticoduodenal artery aneurysm (iPDAA) and coeliac artery (CA) occlusion. The researchers used a two-stage approach, combining open surgical aorto-visceral autologous bypass and interventional coil embolization, to successfully treat the aneurysm and restore normal liver function. The study highlights the importance of combining endovascular and open procedures in individualized therapy approaches to maximize patient outcomes. [Extracted from the article]
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- 2024
9. Controlling the arterial supply into the pancreatic head region as a whole peripancreatic arterial arcade via a mesenteric approach during isolated pancreatoduodenectomy.
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Iede, Kiyotsugu, Nakao, Akimasa, Oshima, Kenji, Suzuki, Ryota, Yamada, Hironori, Tashiro, Mitsuru, Oshima, Yukiko, and Kobayashi, Hironobu
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MULTIDETECTOR computed tomography , *PANCREATICODUODENECTOMY , *SURGICAL blood loss - Abstract
Purpose: The peripancreatic arterial system forms various arterial arcades and collateral branches; therefore, it stands to reason that the arterial supply into the pancreatic head region should be controlled as a whole peripancreatic arterial arcade rather than as the three major supplying arteries during isolated pancreatoduodenectomy (PD). We investigated the clinical importance of early control of the whole peripancreatic arterial arcade during PD. Methods: The subjects of this retrospective study were 63 consecutive patients who underwent PD via a mesenteric approach at our hospital between October, 2014 and February, 2017. The patients were divided into an early control group (n = 27) and a late control group (n = 36) for comparative analysis. Results: The peripancreatic arterial arcades and collateral branches were seen on preoperative multidetector row computed tomography (CT) images and during PD in all 63 patients. The early control group had significantly less intraoperative blood loss than the late control group. Early control of the whole peripancreatic arterial arcade was an independent factor associated with lower intraoperative blood loss in the multivariable analysis (P = 0.012). Conclusion: The arterial supply into the pancreatic head region should be controlled as a whole peripancreatic arterial arcade rather than as the three major supplying arteries during isolated PD. [ABSTRACT FROM AUTHOR]
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- 2021
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10. Balloon-assisted coil embolization (BACE) of a wide-necked aneurysm of the inferior pancreaticoduodenal artery
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Francesco Modestino, Alberta Cappelli, Cristina Mosconi, Giuliano Peta, Antonio Bruno, Giulio Vara, Caterina De Benedictis, and Rita Golfieri
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Visceral aneurysm ,Coils embolization ,Inferior pancreaticoduodenal artery ,Celiac trunk occlusion ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background Aneurysms of the pancreaticoduodenal arcades are an uncommon pathology, with a prevalence of 2%, and could be congenital or acquired. Treatment of visceral aneurysms is therefore generally recommended when the aneurysmal sac equals or exceeds 2 cm. Wide-necked (> 4 mm) and main artery branch aneurysms represent a challenge for conventional endovascular coil embolization due to the risk of coil migration. Main body This case describes the technical feasibility of balloon-assisted coil embolization (BACE) in the treatment a wide neck aneurysm of inferior pancreatic duodenal artery due to celiac axis occlusion. Short conclusion In case of celiac trunk occlusion, BACE is a safe procedure associated with optimal technical success rates, in order to treat the aneurysms and to preserve splanchnic vascularization.
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- 2020
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11. Technical details of a left-side approach to the superior mesenteric artery during pancreaticoduodenectomy.
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Sakamoto, Katsunori, Ogawa, Kohei, Takai, Akihiro, Tamura, Kei, Shine, Mikiya, Matsui, Takashi, Nishi, Yusuke, Utsunomiya, Takeshi, Inoue, Hitoshi, Matsuda, Seiji, and Takada, Yasutsugu
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MESENTERIC artery , *PANCREATICODUODENECTOMY , *ARTERIES , *JEJUNUM , *PANCREAS - Abstract
Background and purpose: To describe the procedure for a left-side approach to the superior mesenteric artery (SMA) during pancreaticoduodenectomy (PD) in a cadaveric study. Operative procedure: After dividing the upper jejunum, the jejunal artery (JA) is followed to its origin. At the cranial side of the JA, the mesojejunum to be dissected is detached from the ventral to the dorsal side and from the peripheral to the origin side of the SMA. The inferior pancreatoduodenal artery (IPDA), which is usually the common trunk of the IPDA and the first JA, is able to be visualized at the cranio-dorsal side of the origin of the JA. After cutting the IPDA, the mesojejunum can be detached from the SMA from the dorsal aspect to the right side. Subsequently, the pancreas head is dissected easily from the right aspect of the SMA. Conclusion: This left-side approach to the SMA may become a standard procedure. [ABSTRACT FROM AUTHOR]
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- 2021
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12. Reports from Emory University School of Medicine Describe Recent Advances in Aneurysm (Inferior Pancreaticoduodenal Artery Pseudoaneurysm Causing Biliary Obstruction: A Case Report).
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FALSE aneurysms ,CHOLANGITIS ,DIGESTIVE system diseases ,ANEURYSMS ,ARTERIES ,ALCOHOLISM ,CARDIOVASCULAR diseases - Abstract
A recent report from Emory University School of Medicine discusses the rare but dangerous condition of visceral arterial aneurysms and pseudoaneurysms. These conditions can result in life-threatening hemorrhage and are often caused by chronic inflammatory processes such as pancreatitis. The report presents a case study of a 64-year-old male patient with a history of alcohol use disorder and chronic pancreatitis who developed an inferior pancreaticoduodenal pseudoaneurysm causing biliary obstruction. The patient was successfully treated with interventional radiology angiography and biliary duct stenting. The research emphasizes the importance of rapid diagnosis and urgent endovascular management to prevent complications and mortality. [Extracted from the article]
- Published
- 2024
13. Indications and Pitfalls of the Modified Distal Pancreatectomy with Celiac Axis En Bloc Resection for Pancreatic Cancer
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Okada, Ken-ichi, Yamaue, Hiroki, and Yamaue, Hiroki, editor
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- 2017
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14. The Role of the Appleby Operation and Arterial Resection in the Multimodality Management of Borderline Resectable Pancreatic Cancer
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Okada, Ken-ichi, Yamaue, Hiroki, Katz, Matthew H.G., editor, and Ahmad, Syed A., editor
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- 2016
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15. Acute pancreatitis complicated with peripancreatic pseudoaneurysm and subsequent intra‐abdominal hematoma.
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Chiang, Hsueh‐Chien, Lo, Yi‐Ning, Chen, Chiung‐Yu, Chuang, Chiao‐Hsiung, Hong, Tzu‐Chun, and Kuo, Hsin‐Yu
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FALSE aneurysms ,INTRA-abdominal hypertension ,HEMATOMA ,PANCREATITIS ,SPLENIC artery ,GASTROINTESTINAL system ,CHRONIC pancreatitis - Abstract
Acute pancreatitis complicated with peripancreatic pseudoaneurysm and subsequent intra-abdominal hematoma Keywords: acute pancreatitis; inferior pancreaticoduodenal artery; intra-abdominal hematoma; peripancreatic pseudoaneurysm EN acute pancreatitis inferior pancreaticoduodenal artery intra-abdominal hematoma peripancreatic pseudoaneurysm 393 394 2 06/02/23 20230501 NES 230501 Acute pancreatitis is a common disease, but peripancreatic pseudoaneurysm is rare. A computed tomography (CT) scan confirmed an intra-abdominal hematoma with a probable aneurysm of the inferior pancreatoduodenal artery (Fig. [Extracted from the article]
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- 2023
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16. Arterial blood supply to the pancreas from accessary middle colic artery.
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Ito, Kyoji, Takemura, Nobuyuki, Inagaki, Fuyuki, Mihara, Fuminori, Kurokawa, Toshiaki, and Kokudo, Norihiro
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An accessory middle colic artery (AMCA) is an aberrant artery feeding the splenic flexure of the colon. Little is known about the branching pattern of an AMCA. We aimed to evaluate the branching pattern of the AMCA from the superior mesenteric artery (SMA) with special reference to the pancreatic artery using multidetector-row computed tomography (MDCT) before surgery. We investigated 112 patients who underwent contrast-enhancement MDCT before surgical resection of the pancreas between January 2015 and July 2018. The pancreatic branch from the AMCA was divided into the dorsal pancreatic artery (DPA) and the inferior pancreaticoduodenal artery (IPDA). The branching level and angle of the AMCA from the SMA were also evaluated. The AMCA was present in 27.7% of patients (n = 31/112). The AMCA branching pattern was classified into four types: type A, no branch from the AMCA (n = 20); type B, a common trunk with the DPA (n = 6); type C, a common trunk with the IPDA (n = 3); and type D, a common trunk with the DPA and IPDA (n = 2). The AMCA with the IPDA (types C and D) branched more proximally compared to the AMCA without the IPDA (P = 0.04). The AMCA branched vertically from the SMA in most cases (n = 24/31, 77.4%). The AMCA had a pancreatic branch in 8.9% (10/112) of cases. Special attention should be paid to its branching pattern in pancreatic and colon surgery. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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17. Endovascular treatment of an inferior pancreaticoduodenal artery aneurysm
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Celine Bodson, Leslie Rémont, and César Vazquez
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Celiac axis stenosis ,embolization ,endovascular ,inferior pancreaticoduodenal artery ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Inferior pancreaticoduodenal artery (IPDA) aneurysm is uncommon. The incidence is about 2% of all visceral arterial aneurysms. The causes are multiples but usually associated with celiac axis stenosis or occlusion. There are mainly asymptomatic and often detected incidentally, but in 30% of cases, symptoms are present. The mortality rate after rupture remains high (40%–60%). Diagnose of an inferior pancreaticoduodenal artery aneurysm associated with celiac axis stenosis or occlusion can be difficult and requires a selective angiography or a multislice computed tomography scan reconstruction. We described the case of an asymptomatic inferior pancreaticoduodenal artery aneurysm associated with a celiac axis stenosis treated by endovascular approach (coils and stent).
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- 2017
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18. Duodenal stenosis after transcatheter arterial embolization for rupture of an inferior pancreaticoduodenal aneurysm
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Yusuke Sawada, Kengo Ohta, Tatsuya Kawai, Keiichi Nagai, Keita Nakayama, Masashi Shimohira, Shunsuke Shibata, and Yuta Shibamoto
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medicine.medical_specialty ,medicine.medical_treatment ,R895-920 ,Inferior pancreaticoduodenal artery ,Case Report ,Duodenal stenosis ,Epigastric pain ,Medical physics. Medical radiology. Nuclear medicine ,Embolization ,Aneurysm ,medicine.artery ,medicine ,Radiology, Nuclear Medicine and imaging ,business.industry ,Arterial Embolization ,medicine.disease ,medicine.anatomical_structure ,Vomiting ,Duodenum ,Radiology ,medicine.symptom ,business ,Complication - Abstract
A 64-year-old man presented with epigastric pain and underwent contrast-enhanced computed tomography. Ruptured aneurysm of the inferior pancreaticoduodenal artery was diagnosed. TAE was successfully accomplished using coils, but vomiting appeared 9 days later. Duodenal stenosis was diagnosed from contrast-enhanced computed tomography and upper gastrointestinal endoscopy and was attributed to edematous changes in the duodenum. Conservative management led to successful recovery and discharge.
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- 2021
19. Approaching the superior mesenteric artery from the right side using the proximal-dorsal jejunal vein preisolation method during laparoscopic pancreaticoduodenectomy.
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Nagakawa, Yuichi, Hosokawa, Yuichi, Sahara, Yatsuka, Takishita, Chie, Hijikata, Yosuke, Osakabe, Hiroaki, Nakajima, Tetsushi, Shirota, Tomoki, Katsumata, Kenji, Nakamura, Masafumi, and Tsuchida, Akihiko
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PANCREATICODUODENECTOMY , *MESENTERIC artery , *MESENTERIC veins , *SURGICAL excision , *MULTIDETECTOR computed tomography - Abstract
Background: Although the artery-first approach is widely used in open pancreaticoduodenectomy, it is difficult to laparoscopically expose the origin of the inferior pancreaticoduodenal artery (IPDA) from the left side of the superior mesenteric artery (SMA). By contrast, damaging the inferior pancreaticoduodenal veins (IPDVs) is possible when approaching the IPDA from the right side of the SMA. To facilitate the artery-first approach in laparoscopic pancreaticoduodenectomy (LPD), we focused on the proximal-dorsal jejunal vein (PDJV) that branched from the superior mesenteric vein (SMV) dorsal side and drained the IPDVs. This study aimed to clarify the usefulness of the right SMA approach using the PDJV preisolation method.Methods: The PDJV was first isolated, and the IPDVs were divided along the PDJV on the right side of the SMA. Then, the IPDA was divided at the root without first separating the pancreatic head from the portal vein and the SMV. Overall, 21 patients underwent this approach, and the results were retrospectively compared with those of 21 patients who underwent the artery-first approach, which was performed on the left side of the SMA. Anatomical characteristics of the PDJV were evaluated using multidetector computed tomography for the two groups.Results: Operative times and resection times were significantly lower for the PDJV preisolation group than for the conventional LPD group (489.3 vs. 541.7 min, respectively; p = 0.002). During anatomical evaluation, 41 patients (97.6%) had a PDJV that drained from the SMV dorsally and was in contact with the anterior aspect of the uncinate process. The PDJV was confirmed as the first jejunal vein in 31 patients (73.8%) and as the second jejunal vein in 10 patients (23.8%).Conclusions: This approach facilitates dissection of the IPDA on the right side of the SMA, thereby reducing operative times. [ABSTRACT FROM AUTHOR]- Published
- 2018
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20. A Rare Branching Pattern of a Middle Mesenteric Artery Supplying the Head of the Pancreas and the Transverse Colon.
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Venieratos, Dionysios, Tsoucalas, Gregory, and Panagouli, Eleni
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MESENTERIC artery , *ABDOMINAL aorta , *PANCREAS , *AORTA , *ARTERIAL dissections - Abstract
Objective. The appearance of a middle mesenteric artery is a rare branching variation, with an incidence lower than 0.1%. Our case reports such an anatomical artery pattern which was discovered in a male Caucasian cadaver during routine educational dissection. This alternation is seldom encountered and may trouble diagnostic and surgical interventions. Case Report. The case of a Middle Mesenteric Artery is described, as a vessel originating from the Abdominal Aorta 3.3 cm below the origin of the Superior Mesenteric and 3.8 cm above the origin of the Inferior Mesenteric Artery. The middle mesenteric artery, directed upwards, gives two branches for supplying blood to the head of the pancreas. We first mention the thinner branch, corresponding to the posterior one of the inferior pancreaticoduodenal artery, and second the thicker branch corresponding to the anterior branch of the Inferior Pancreaticoduodenal Artery. The main artery continues its course between the two sheets of the mesocolon to supply the transverse colon, thus substituting the normal colic artery. Conclusion. The occurrence of a Middle Mesenteric Artery constitutes a very rare anatomic variation. We present, to our knowledge, the first case described where the Middle Mesenteric Artery provides blood to the pancreas. [ABSTRACT FROM AUTHOR]
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- 2018
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21. Akute rechtsseitige Oberbauchschmerzen bei einer 46-Jährigen.
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Bauder, M., Fiala, A., Klinger, C., Kersjes, W., and Caca, K.
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Copyright of Der Internist is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2018
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22. Preventive covered stent placement at the gastroduodenal artery stump in angiogram-negative sentinel hemorrhage after pancreaticoduodenectomy
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Hsuen-En Huang, Hsiuo-Shan Tseng, Yuan-Mao Lin, Yi-Ming Shyr, Shin-E Wang, Chien-An Liu, Rheun-Chuan Lee, and Ethan Y. Lin
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medicine.medical_specialty ,Urology ,medicine.medical_treatment ,030218 nuclear medicine & medical imaging ,Gastroduodenal artery ,03 medical and health sciences ,Pseudoaneurysm ,0302 clinical medicine ,medicine.artery ,Internal medicine ,medicine ,Radiology, Nuclear Medicine and imaging ,cardiovascular diseases ,Covered stent ,Computed tomography angiography ,Radiological and Ultrasound Technology ,medicine.diagnostic_test ,business.industry ,Gastroenterology ,Inferior pancreaticoduodenal artery ,Hepatology ,Pancreaticoduodenectomy ,medicine.disease ,Surgery ,030220 oncology & carcinogenesis ,Angiography ,business - Abstract
To evaluate the clinical outcomes of preventive covered stent placement at the gastroduodenal artery stump in patients with angiogram-negative sentinel hemorrhage after pancreaticoduodenectomy. Between July 2006 and September 2018, patients undergoing computed tomography angiography or diagnostic angiography for sentinel hemorrhage after pancreaticoduodenectomy were retrospectively reviewed. Patients having angiogram-negative angiography and undergoing preventive covered stent placement or conservative treatment were included. Clinical outcomes, technique success, and complications were evaluated. A total of 25 patients (mean age 62.5 years) were evaluated, including 15 patients underwent preventive covered stent placement at the gastroduodenal artery stump and 10 patients received conservative treatments. The clinical success rates were 50% (5/10) and 86.7% (13/15) for conservative treatments and covered stent groups, respectively (p = 0.07). In the conservative treatment group, delayed massive hemorrhage occurred in five patients, two of whom died of recurrent bleeding due to gastroduodenal artery pseudoaneurysm within 16 days, and two had intraluminal hemorrhage within 5 days. In the covered stent group, one patient had inferior pancreaticoduodenal artery pseudoaneurysm 1 day after the placement of the covered stent, and one had recurrent bleeding due to duodenal ulcer within 14 days. The 30-day mortality was 40% (4/10) and 0 in the conservative treatment and covered stent groups, respectively (p = 0.02). The difference in the overall survival was nonsignificant between the two groups (p = 0.23). The preventive covered stent placement at the gastroduodenal artery stump is safe and reduces delayed massive hemorrhage and short-term mortality in patients with angiogram-negative sentinel hemorrhage after pancreaticoduodenectomy.
- Published
- 2021
23. Pseudoaneurysm of the Inferior Pancreaticoduodenal Artery Due to Cholecystitis
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Jayan George, Samuel Besant, Trevor Cleveland, and Ahmed Al-Mukhtar
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Pseudoaneurysm ,cholecystitis ,inferior pancreaticoduodenal artery ,Medicine (General) ,R5-920 ,Medical physics. Medical radiology. Nuclear medicine ,R895-920 - Abstract
Inferior pancreaticoduodenal artery pseudoaneurysms and aneurysms are a rare occurrence, comprising of approximately 10% of visceral artery aneurysms and pseudoaneurysms. The cause is normally due to trauma, iatrogenic or pancreatitis. We present a case of a patient re-presenting to hospital following treatment of acute cholecystitis with epigastric pain, dysphagia, pyrexia, nausea, vomiting and an acute kidney injury. Following cholecystostomy, intravenous fluids and conservative treatment for her symptoms, she failed to improve significantly and was found to have a 6 mm pseudoaneurysm of the inferior pancreaticoduodenal artery on day twenty of her admission. She was transferred to a tertiary centre and was treated with an embolisation and recovered well from the procedure.
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- 2019
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24. Common hepatic artery originating from superior mesenteric artery with replaced right hepatic artery
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Michiko Naito, Takuya Omotehara, Kazuyuki Shimada, Shinichi Kawata, Shogo Hayashi, and Masahiro Itoh
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Superior pancreaticoduodenal artery ,Common hepatic artery ,business.industry ,Inferior pancreaticoduodenal artery ,General Medicine ,Anatomy ,Collateral circulation ,Gastroduodenal artery ,medicine.anatomical_structure ,Celiac artery ,medicine.artery ,medicine ,Duodenum ,Superior mesenteric artery ,business - Abstract
We found a variational case relating to the arteries distributed to the liver and pancreas during the routine cadaver dissection course. The common hepatic artery originated from the superior mesenteric artery as the first branch. The common hepatic artery was soon divided into the left and right hepatic arteries and distributed to the left and right lobe of the liver. The superior pancreaticoduodenal artery arose from the gastroduodenal artery, a branch of the left hepatic artery. The inferior pancreaticoduodenal artery originated from the superior mesenteric artery. Besides, two posterior branches of the right hepatic artery supplied the duodenum and the head of the pancreas. The arterial arcades were formed behind the head of the pancreas among the superior pancreaticoduodenal artery and these two posterior branches of the right hepatic artery. In conclusion, this case can be considered a rare case in which the replaced common hepatic artery and replaced right hepatic artery occurred simultaneously. The coexisting of these two replaced arteries suggests that the developmental processes to form these variations are independent.
- Published
- 2021
25. What comprises the plate-like structure between the pancreatic head and the celiac trunk and superior mesenteric artery? A proposal for the term 'P–A ligament' based on anatomical findings
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Daisuke Ban, Keiichi Akita, Satoru Muro, Wachirawit Sirirat, and Yuichi Nagakawa
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Male ,03 medical and health sciences ,Hepatic Artery ,0302 clinical medicine ,Celiac Artery ,Mesenteric Artery, Superior ,Cadaver ,P–A ligament ,medicine.artery ,Humans ,Medicine ,Superior mesenteric artery ,Pancreas ,Aged ,Aged, 80 and over ,Plexus ,Aorta ,Ligaments ,business.industry ,Inferior pancreaticoduodenal artery ,Pancreatic head plexus ,Surgical anatomy ,General Medicine ,Anatomy ,Mesopancreas ,Trunk ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Ligament ,Female ,Original Article ,030211 gastroenterology & hepatology ,business - Abstract
A plate-like structure is located posterior to the portal vein system, between the pancreatic head and roots and/or branches of two major arteries of the aorta: the celiac trunk and superior mesenteric artery. We aimed to clarify the distribution and components of this plate-like structure. Macroscopic examination of the upper abdomen and histological examination of the plate-like structure were performed on 26 cadavers. The plate-like structure is connected to major arteries (aorta, celiac trunk, superior mesenteric artery) and the pancreatic head; it contains abundant fibrous bundles comprising nerves, vessels, collagen fibers, and adipose tissue. Furthermore, it consists of three partly overlapping fibrous components: rich fibrous bundles (superior mesenteric artery plexus) fused to the uncinate process of the pancreas; fibrous bundles arising from the right celiac ganglion and celiac trunk that spread radially to the dorsal side of the pancreatic head and superior mesenteric artery plexus; and fibrous bundles, accompanied by the inferior pancreaticoduodenal artery, entering the pancreatic head. The plate-like structure is the pancreas–major arteries (aorta, celiac trunk, superior mesenteric artery) ligament (P–A ligament). The term “P–A ligament” may be clinically useful and can facilitate comprehensive understanding of the anatomy surrounding the pancreatic head and provide an anatomical basis for further pancreatic surgery studies.
- Published
- 2021
26. Distance from Left Renal Vein to Inferior Pancreaticoduodenal Artery: A Landmark for Identifying Inferior Pancreaticoduodenal Artery in Pancreatoduodenectomy.
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Tomimaru, Yoshito, Tanaka, Kaishu, Noguchi, Kozo, Hatano, Hisanori, Eguchi, Hidetoshi, and Dono, Keizo
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PANCREATICODUODENECTOMY , *RENAL veins - Abstract
Background/Aim: During pancreatoduodenectomy, early ligation of major afferent arteries to pancreatic head prior to dissection of the corresponding veins may reduce intraoperative bleeding. Inferior pancreaticoduodenal artery (IPDA), one of the major afferent arteries, is difficult to identify. We measured the distance from left renal vein to IPDA based on preoperative multi-detector row computed tomography (MDCT) images for use as a new landmark for IPDA. Methods: The distance between left renal vein and IPDA was measured in 417 patients using MDCT images. Results: IPDA was identified on MDCT images in 415 out of the 417 patients (99.5%). The root of IPDA was located on cranial side of the root of left renal vein in 88 among the 415 patients (21.2%), and the distance was expressed as negative in these cases. The distance was 6.09 ± 7.46 mm. The distance when IPDA formed a common vessel with first jejunal artery (8.03 ± 6.74 mm; 323 cases, 77.8%) was significantly longer than when IPDA branched directly from superior mesenteric artery (SMA; -0.81 ± 5.74 mm; 62 cases, 15.0%) or posterior and anterior IPDAs branched separately from SMA (-2.04 ± 5.36 mm; 30 cases, 7.2%). Conclusions: The distance between left renal vein and IPDA can serve as a landmark for IPDA identification. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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27. Spontaneous rupture of the pancreatic arcade artery caused by neurofibromatosis type 1 successfully treated using emergency transcatheter arterial embolization, partial intra-aortic balloon occlusion, and stent graft placement: a case report and review of the literature
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Ryo Morita, Yuki Yoshino, Kohsuke Kudo, Toru Yoshikawa, Takeshi Soyama, Daisuke Abo, and Tasuku Kimura
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Stent-graft placement ,Abdominal pain ,medicine.medical_specialty ,lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_treatment ,Endovascular therapy ,Case Report ,Vasculopathy ,Spontaneous rupture ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Pancreatic arcade artery ,medicine.artery ,medicine ,Radiology, Nuclear Medicine and imaging ,Superior mesenteric artery ,medicine.diagnostic_test ,business.industry ,Arterial Embolization ,Inferior pancreaticoduodenal artery ,Stent ,Interventional radiology ,Surgery ,medicine.anatomical_structure ,Blood pressure ,lcsh:RC666-701 ,030220 oncology & carcinogenesis ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Intra-aortic balloon occlusion ,Artery ,Neurofibromatosis type 1 - Abstract
Background Vascular abnormalities in neurofibromatosis type 1 (NF1) are rare, but are the second leading cause of death in persons with NF1. In NF1 vasculopathy (NF-V), fatal bleeding due to a spontaneous arterial rupture sometimes occurs. Ruptured extracranial arteries in patients with NF1 often involve thoracic vessels, such as the intercostal and subclavian arteries; very few reports exist regarding the abdominal region. Herein, we present the first case of intraperitoneal bleeding due to spontaneous pancreatic arcade artery (PAA) rupture associated with NF1, successfully treated by transcatheter arterial embolization (TAE) combined with stent-graft placement and partial intra-aortic balloon occlusion (IABO). Case presentation A 40-year-old woman complained of back and abdominal pain. Upon admission, her blood pressure was 85/41 mmHg and heart rate was 129 beats/min. Computed tomography (CT) showed large intraperitoneal bleeding due to PAA rupture. After CT scanning, her systolic blood pressure decreased to 50 mmHg. Therefore, we performed emergency TAE with partial IABO. She was treated by TAE of the anterior superior pancreaticoduodenal artery, anterior inferior pancreaticoduodenal artery, and inferior pancreaticoduodenal artery. However, even after TAE, minor extravasation around the superior mesenteric artery continued, and her vital signs remained unstable. Stent-graft placement was selected to stop the haemorrhage, preserving normal blood flow of the superior mesenteric artery trunk. Excellent patency of the stent graft was confirmed on follow-up CT, and she was discharged on postoperative day 56. Conclusion PAA rupture associated with NF1 can be successfully treated by TAE combined with partial intra-aortic balloon occlusion, and stent-graft placement.
- Published
- 2020
28. Dorsal Pancreatic Artery—a Study of Its Detailed Anatomy for Safe Pancreaticoduodenectomy
- Author
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H Yamada, Teppei Tatsuoka, Y Harihara, M Nakata, Takuji Noro, and T Noie
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medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,fungi ,Inferior pancreaticoduodenal artery ,Dorsal pancreatic artery ,Anatomy ,Pancreaticoduodenectomy ,Cardiac surgery ,Gastroduodenal artery ,Plastic surgery ,medicine.anatomical_structure ,Cardiothoracic surgery ,medicine.artery ,medicine ,Surgery ,Superior mesenteric artery ,business - Abstract
Early division of the dorsal pancreatic artery (DPA) or its branches to the uncinate process during pancreaticoduodenectomy (PD) in addition to early division of the gastroduodenal artery and inferior pancreaticoduodenal artery should be performed to reduce blood loss by completely avoiding venous congestion. However, the significance of early division of DPA or its branches to the uncinate process has not been reported. The aim of this study was to investigate the anatomy of DPA and its branches to the uncinate process using the currently available high-resolution dynamic computed tomography (CT) as the first step to investigate the significance of DPA in the artery-first approach during PD. Preoperative dynamic thin-slice CT data of 160 consecutive patients who underwent hepato–pancreato–biliary surgery were examined focusing on the anatomy of DPA and its branches to the uncinate process. DPA was recognized in 103 patients (64%); it originated from the celiac axis or its branches in 70 patients and from the superior mesenteric artery or its branches in 34 patients. The branches to the uncinate process were visualized in 82 patients (80% of those with DPA), with diameters of 0.5–1.5 mm in approximately 80% of the 82 patients irrespective of DPA origin. DPA branches to the uncinate process were recognized using high-resolution CT in approximately half of the patients.
- Published
- 2020
29. Inferior pancreaticoduodenal artery aneurysms and Dunbar syndrome. Experience with the open surgery
- Author
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Predrag Pavić, Inga Đaković Bacalja, Tomislav Meštrović, and Ali Allouch
- Subjects
medicine.medical_specialty ,Abdominal pain ,abdominal pain ,Dunbar syndrome ,median arcuate ligament ,postprandial pain ,visceral aneurysm ,Asymptomatic ,03 medical and health sciences ,0302 clinical medicine ,Aneurysm ,Median Arcuate Ligament Syndrome ,Celiac Artery ,Mesenteric Artery, Superior ,medicine.artery ,Occlusion ,medicine ,Humans ,business.industry ,Median arcuate ligament ,Inferior pancreaticoduodenal artery ,General Medicine ,medicine.disease ,Abdominal Pain ,Surgery ,Stenosis ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Female ,030211 gastroenterology & hepatology ,medicine.symptom ,business ,Artery - Abstract
Introduction: Median arcuate ligament or Dunbar syndrome is a rare vascular disorder causing celiac trunk stenosis or occlusion due to the extrinsic compression by the median arcuate ligament. A visceral aneurysm may develop as a complication.Patients and methods: We experienced an inferior pancreaticoduodenal artery aneurysm presentation in two female patients with the median arcuate syndrome previously diagnosed. One patient presented with postprandial abdominal pain and weight loss and the other one was asymptomatic.Results: We described our experience with the both patients being successfully treated surgically.Conclusions: Awareness of possible repercussions of the celiac trunk stenosis to peripancreatic arteries should be elevated. Restoration of physiological blood flow by removing pathologic anatomy should be performed. Since there is no correlation between the size of a visceral aneurysm and the risk of rupture, having a high postrupture mortality, pancreaticoduodenal artery aneurysms should be treated even if asymptomatic. Surgical treatment remains the mainstay treatment of the Dunbar syndrome complicated by visceral aneurysms.
- Published
- 2020
30. Pancreas transplantation with isolated splenic artery blood supply – Single center experience
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A G Balkarov, Irina V. Khodilina, R.V. Storozhev, Y. Anisimov, A V Pinchuk, Aleksandr S. Kondrashkin, Rustam Sh Muslimov, and I. V. Dmitriev
- Subjects
Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,lcsh:Surgery ,Transplants ,Splenic artery ,Pancreas transplantation ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,medicine.artery ,medicine ,Humans ,Superior mesenteric artery ,Pancreas ,Laparotomy ,Common hepatic artery ,business.industry ,Inferior pancreaticoduodenal artery ,Blood flow ,lcsh:RD1-811 ,Mesenteric Arteries ,Surgery ,Perfusion ,Transplantation ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Carbohydrate Metabolism ,Female ,030211 gastroenterology & hepatology ,Pancreas Transplantation ,business ,Splenic Artery ,Vascular Surgical Procedures - Abstract
Summary: Background: The blood supply of the native pancreas by three arterial lines from the celiac trunk system (splenic artery and common hepatic artery) and the superior mesenteric artery forces surgeons to perform vascular reconstruction to provide sufficient intra-organ blood flow into the graft. The purpose of our study was to assess the possibility of pancreas transplantation with an isolated splenic artery blood supply. Methods: From January 2012 to July 2018, simultaneous pancreas-kidney transplantation (SPKT) was performed in 21 patients. Gender: male – 11 (52,4%), female 10 (47,6%). Recipients aged 26 to 54, the median age was 38 [34; 42] years. In 6 (28,6%) recipients, the organ perfusion was carried out through the splenic artery alone; in the rest, it was performed through the splenic and inferior pancreaticoduodenal artery exiting from the superior mesenteric artery of the graft. The transplant function, the quality of carbohydrate metabolism compensation, the objective characteristics of intra-organ blood flow was assessed. Results: There were no statistically significant differences in the volume blood flow characteristics revealed by CT-perfusion and laboratory data in the study groups. Conclusions: Based on the assessment of the function and quality of blood supply to the transplant, the possibility of performing pancreas transplantation with an isolated splenic artery blood supply had been proved. Keywords: Pancreas transplantation, CT perfusion, Blood supply
- Published
- 2020
31. Small Bowel Obstruction: A Rare Presentation of the Inferior Pancreaticoduodenal Artery Pseudoaneurysm Bleed
- Author
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Zaid Iqbal, Muhammad Sabih Saleem, Hammed Ninalowo, Yakub I Khan, and Hasan M Zerti
- Subjects
medicine.medical_specialty ,business.industry ,Gastroenterology ,General Engineering ,pseudoaneurysm ,Inferior pancreaticoduodenal artery ,Clinical manifestation ,Bleed ,medicine.disease ,intra-abominal bleed ,inferior pancreaticoduodenal artery ,Gastroduodenal artery ,Bowel obstruction ,Pseudoaneurysm ,Hematoma ,medicine.artery ,Internal Medicine ,cardiovascular system ,medicine ,cardiovascular diseases ,Radiology ,Presentation (obstetrics) ,gastroduodenal artery ,intramural hematoma ,business - Abstract
Intra-abdominal and intramural hematomas are well-known complications of pseudoaneurysms. We present a case of small bowel obstruction as a result of external mechanical compression from hematoma. Bleeding was localized to the pseudoaneurysm of the gastroduodenal artery and inferior pancreaticoduodenal artery. Angiography was used to control the bleeding with coil embolization. This rare clinical manifestation represents just one of the symptoms associated with pseudoaneurysms of the gastrointestinal tract. Therapeutic options are discussed along with a review of the literature.
- Published
- 2021
32. Ilio-Hepatic Artery Bypass for Hypoplasia of the Celiac Axis and Its Branches with an Inferior Pancreaticoduodenal Artery Aneurysm
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Masaru Nemoto, Yutaka Takayama, Yu Tadokoro, Junji Yamamoto, and Tatsuki Watanabe
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hypoplasia ,medicine.medical_specialty ,business.industry ,Occlusive disease ,Celiac axis ,Inferior pancreaticoduodenal artery ,Case Report ,General Medicine ,Blood flow ,medicine.disease ,Hypoplasia ,Surgery ,medicine.anatomical_structure ,Aneurysm ,medicine.artery ,medicine ,inferior pancreaticoduodenal artery aneurysm ,Autologous Vein Graft ,ilio-hepatic artery bypass ,business ,Artery - Abstract
Hemorrhage due to a ruptured pancreaticoduodenal artery aneurysm is potentially fatal. We describe a case of a 51-year-old man, incidentally diagnosed with an inferior pancreaticoduodenal artery aneurysm associated with probable congenital hypoplasia of the celiac axis and its branches. Considering the rupture risk, we performed an ilio-hepatic artery bypass with an autologous vein graft and aneurysmorrhaphy. The postoperative course was uneventful. At the 24-month follow-up, the bypass was patent, with no aneurysm recurrence. The ilio-hepatic artery bypass is effective and preserves visceral blood flow. However, the iliac artery is susceptible to occlusive disease, and long-term follow-up is required.
- Published
- 2021
33. Resection and reconstruction of pancreatic artery aneurysms caused by the compression of the celiac trunk by the median arcuate ligament: a report of two cases
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Takehiko Aoyagi, Mayumi Ishida, Eiji Tsujita, Yoshinari Nobuto, Keita Natsugoe, Tomohiro Iguchi, Yuta Kasagi, Sosei Kuma, Hideaki Uchiyama, and Hiroyuki Itoh
- Subjects
medicine.medical_specialty ,RD1-811 ,medicine.medical_treatment ,Case Report ,030204 cardiovascular system & hematology ,Anastomosis ,03 medical and health sciences ,0302 clinical medicine ,Aneurysm ,medicine.artery ,medicine ,Superior mesenteric artery ,Rupture ,business.industry ,Median arcuate ligament ,Inferior pancreaticoduodenal artery ,Stent ,Resection and reconstruction ,Jejunal arteries ,biochemical phenomena, metabolism, and nutrition ,medicine.disease ,Trunk ,Surgery ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,business ,Pancreatic artery aneurysm - Abstract
Background Some patients with the compression of the celiac trunk by the median arcuate ligament (MAL) suffer pancreatic artery aneurysms (PAAs) due to excessive blood flow from the superior mesenteric artery. These aneurysms are in peril because they are prone to rupture irrespective of size. Here, we present two cases of resection and reconstruction of PAAs caused by the compression of the celiac trunk by the MAL. Case presentation Patient 1 was a 44-year-old man who was first diagnosed to have a visceral artery aneurysm with a diameter of 4 cm accidentally found by ultrasound examination at a regular medical check-up. Contrast-enhanced CT revealed the compression of the celiac trunk by the MAL and a PAA originating from the first jejunal artery. First, laparoscopic excision of the MAL followed by a stent placement into the celiac trunk was performed. Although the stent was patent, the PAA still grew. The patient underwent resection and reconstruction of the PAA. Reconstruction of the pancreatic arterial arcade was needed because clamping of the inferior pancreaticoduodenal artery (IPDA) resulted in disappearance of the hepatic arterial blood flow. The follow-up CT 2 years and 9 months after the operation revealed no recurrence of aneurysms and the patent anastomosis. Patient 2 was a 68-year-old man who presented with an epigastric pain. Contrast-enhanced CT revealed the compression of the celiac trunk by the MAL and a PAA approximately 6 cm in diameter originating from the IPDA. The PAA was surrounded by a relatively low-intensity area, suggesting impending rupture of the PAA. The patient underwent resection and reconstruction of the PAA under an emergency situation. Reconstruction of the pancreatic arterial arcade was needed because clamping of the inflow IPDA resulted in disappearance of the hepatic blood flow. The follow-up CT 1 year and 8 months after the operation revealed no recurrence of aneurysms and the patent anastomosis. Conclusions Although long-term follow-up is needed, resection and reconstruction is one of the therapeutic choices for PAAs caused by the compression of the celiac trunk by the MAL in order to prevent catastrophic aneurysm rupture.
- Published
- 2021
34. An Undiagnosed Case of Chronic Pancreatitis With Multiple Visceral Arteries Pseudoaneurysm
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Muhammad Anwar, Qazi Kamran Amin, Hira Khalil, Zaland Ahmed Yousafzai, and Nouman Anthony
- Subjects
medicine.medical_specialty ,peptide hydrolases ,Splenic artery ,gastro-duodenal artery pseudo aneurysm ,thrombosed pseudo aneurysm of superior pancreaticoduodenal artery ,Gastroduodenal artery ,Pseudoaneurysm ,Aneurysm ,medicine.artery ,Internal Medicine ,medicine ,ethylene-vinyl alcohol copolymer ,Superior mesenteric artery ,medicine.diagnostic_test ,business.industry ,General Engineering ,Inferior pancreaticoduodenal artery ,medicine.disease ,celiac axis trifurcation pseudo aneurysm ,false aneurysm ,splanchnic artery pseudo aneurysm coiling and embolization ,trisacryl gelatin microspheres ,medicine.anatomical_structure ,General Surgery ,Angiography ,Duodenum ,Radiology ,splanchnic pseudo aneurysms ,business ,pseudo aneurysm in jejunoileal branch of superior mesenteric artery - Abstract
Visceral artery aneurysms, which could be either true or pseudo, are abnormal focal dilations of vessels supplying the abdominal organs. True aneurysms, by definition, suggest dilation of the vessel in response to increased blood flow, ultimately causing a blood-filled sac to form. Pseudoaneurysm, however, is the pooling of blood in surrounding tissues secondary to trauma or rupture. A 43-year-old woman G9 P9, known hypertensive was admitted electively for investigation of melena, hematemesis, hematochezia for one week along with weight loss and epigastric pain. Laboratory studies showed mild anemia with a hemoglobin level of 9.6 g/dL, hematocrit 29.5%, mean corpuscular hemoglobin (MCH) 26.7, upon which she was transfused two pints of blood and commenced at Injectable Vitamin K, injectable transamine, and infusion omeprazole. Two days later her levels improved to HB 12.4 g/dL, hematocrit 37.5%, MCH 26.7 pg, RBC 4.64 × 10*12/L. while being on treatment, a computed tomography (CT) mesenteric angiography was also conducted that showed multiple splanchnic pseudoaneurysms involving celiac axis trifurcation, gastroduodenal artery, superior/inferior pancreaticoduodenal artery, and jejunoileal branch of the superior mesenteric artery, and a large partially thrombosed pseudoaneurysm arising from superior pancreaticoduodenal branch causing significant mass effect on the second part of duodenum. On the basis of such findings, it was advised to perform coiling and embolization of the corresponding arteries. Multiple other small aneurysms with secondary arteriovenous malformations (AVM) were also seen. The whole circuit of flow retrograde and antegrade along with the aneurysm sac was blocked with multiple coils of variable sizes. An angiogram was repeated that revealed a good outcome. Pseudoaneurysms of the visceral arteries are very rare and affect mainly the splenic artery. The rarest of which is gastroduodenal artery (1.5%), pancreaticoduodenal artery (2%), and coeliac truck (4%). Therefore, this can be an incidental finding. The diagnosis is usually made with an angiography combined with clinical presentation. Variable treatment options are available depending on the patient’s fitness and hemodynamic stability. The endovascular approach, however, is mostly used in such cases.
- Published
- 2021
35. Meenakshi Mission Hospital and Research Centre Researcher Describes Research in Cholecystectomy (Endovascular embolization of inferior pancreaticoduodenal artery pseudoaneurysm post-laparoscopic cholecystectomy in a patient with celiac artery...).
- Subjects
CELIAC artery ,FALSE aneurysms ,CHOLECYSTECTOMY ,THERAPEUTIC embolization ,ARTERIES ,RADIOLOGY ,DIGITAL subtraction angiography - Abstract
Angiology, Cholecystectomy, Embolization, Gastroenterology, Health and Medicine, Inferior Pancreaticoduodenal Artery, Stenosis, Surgery Keywords: Angiology; Cholecystectomy; Embolization; Gastroenterology; Health and Medicine; Inferior Pancreaticoduodenal Artery; Stenosis; Surgery EN Angiology Cholecystectomy Embolization Gastroenterology Health and Medicine Inferior Pancreaticoduodenal Artery Stenosis Surgery 280 280 1 03/27/23 20230330 NES 230330 2023 MAR 27 (NewsRx) -- By a News Reporter-Staff News Editor at Hematology Week -- Research findings on cholecystectomy are discussed in a new report. [Extracted from the article]
- Published
- 2023
36. Research in the Area of Aneurysm Reported from Katsuragi Hospital (A Ruptured Inferior Pancreaticoduodenal Artery Aneurysm Detected With Ultrasonography: A Case Report).
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ANEURYSMS ,ULTRASONIC imaging ,ARTERIES ,FALSE aneurysms ,HOSPITALS ,CARDIOVASCULAR diseases - Published
- 2023
37. Rupture of an Idiopathic Aneurysm of the Inferior Pancreaticoduodenal Artery Leading to an Intra-Abdominal Bleeding
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Harbi Khalayleh, Deeb Khoury, Guy Lin, Riham Imam, and Ashraf Imam
- Subjects
Gastroduodenal artery ,medicine.medical_specialty ,Pseudoaneurysm ,Aneurysm ,business.industry ,medicine.artery ,medicine ,Inferior pancreaticoduodenal artery ,business ,medicine.disease ,Surgery - Published
- 2020
38. Inferior pancreaticoduodenal artery pseudoaneurysm in a patient with calculous cholecystitis: A case report
- Author
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Jiang Yan, Qiaodong Xu, Zhihua Lin, Jiahong Liang, Shaodong Zheng, Pei-Dong Zhang, and Songgang Gu
- Subjects
medicine.medical_specialty ,business.industry ,Calculous cholecystitis ,Inferior pancreaticoduodenal artery ,Coil embolization ,General Medicine ,Gastrointestinal haemorrhage ,medicine.disease ,Surgery ,03 medical and health sciences ,Pseudoaneurysm ,Inferior pancreaticoduodenal artery pseudoaneurysm ,0302 clinical medicine ,030220 oncology & carcinogenesis ,medicine.artery ,Case report ,medicine ,Cholecystitis ,cardiovascular system ,030211 gastroenterology & hepatology ,cardiovascular diseases ,business - Abstract
BACKGROUND Pancreaticoduodenal artery (PDA) aneurysms are extremely rare. The complicated clinical presentations and high incidence of rupture make it difficult to diagnose and treat. PDA pseudoaneurysms often rupture into the gastrointestinal tract and result in life-threatening gastrointestinal hemorrhage. CASE SUMMARY A 69-year-old man was admitted to our hospital due to right upward abdominal pain. A computed tomography (CT) scan demonstrated acute cholecystitis and cholecystolithiasis. Percutaneous gallbladder drainage was performed subsequently. He was discharged after 3 d and readmitted to hospital for cholecystectomy as arranged 1 mo later. A repeat CT scan revealed an emerging enhancing mass between the pancreatic head and the descending duodenum. Then, he suffered hematochezia and hemorrhagic shock suddenly. Emergency percutaneous angiogram was performed and selective catheterization of the superior mesenteric artery demonstrated a pseudoaneurysm in the inferior PDA. Coil embolization was performed and his clinical condition improved quickly after embolization and blood transfusion. He underwent laparoscopic cholecystectomy and was discharged from hospital after surgery under satisfactory conditions. CONCLUSION PDA pseudoaneurysms are uncommon. Acute haemorrhage is a severe complication of pseudoaneurysm with high mortality which clinicians should pay attention to.
- Published
- 2019
39. A Unique Communicating Arterial Branch between the Celiac Trunk and the Superior Mesenteric Artery: A Case Report
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Nannette Morales-Marietti, Adegbenro Omotuyi John Fakoya, Thomas McCracken, Zachary T. Vandeveer, Abayomi Gbolahan Afolabi, Emilio Aguinaldo, Erica Barnes, and Natalia M. Velasco-Nieves
- Subjects
lcsh:Medicine ,Case Report ,030209 endocrinology & metabolism ,Anastomosis ,Asymptomatic ,Superior Mesenteric Artery ,03 medical and health sciences ,0302 clinical medicine ,Anterior inferior pancreaticoduodenal artery ,medicine.artery ,Occlusion ,medicine ,030212 general & internal medicine ,Superior mesenteric artery ,Anterior Inferior Pancreaticoduodenal Artery ,Superior Mesentery Artery ,business.industry ,lcsh:R ,Abdominal aorta ,nutritional and metabolic diseases ,Inferior pancreaticoduodenal artery ,General Medicine ,Anatomy ,Trunk ,digestive system diseases ,Abdominal Aorta ,medicine.symptom ,business ,Celiac Trunk - Abstract
BACKGROUND: Many anatomical variations have been associated with the Celiac Trunk, of which most are classified as being asymptomatic. CASE PRESENTATION: In this article, we describe yet another anatomical variation involving the Celiac Trunk, Superior Mesenteric artery and the Inferior Pancreaticoduodenal Artery during routine cadaveric dissection. We identified a fourth branch of the Celiac trunk (quadrification) that communicated with the Superior Mesenteric artery at the point of origin of the Inferior Pancreaticoduodenal artery which we concluded to be the Anterior Inferior Pancreaticoduodenal artery. CONCLUSION: This anastomosis could be essential in the case of occlusion between the Celiac Trunk and the Superior Mesenteric artery.
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- 2019
40. Ruptured pancreaticoduodenal artery aneurysm presenting with duodenal obstruction
- Author
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Zeyad A. Metwalli and Nakul E. Reddy
- Subjects
lcsh:Medical physics. Medical radiology. Nuclear medicine ,medicine.medical_specialty ,Gastrointestinal bleeding ,Abdominal pain ,medicine.medical_treatment ,lcsh:R895-920 ,Duodenal stenosis ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Aneurysm ,Celiac artery ,medicine.artery ,Interventional Radiology ,medicine ,Radiology, Nuclear Medicine and imaging ,Embolization ,cardiovascular diseases ,business.industry ,Median arcuate ligament ,Inferior pancreaticoduodenal artery ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Duodenal obstruction ,cardiovascular system ,medicine.symptom ,business ,030217 neurology & neurosurgery ,Pancreaticoduodenal artery aneurysm - Abstract
Visceral aneurysms of the pancreaticoduodenal arcades are rare. Although these aneurysms are often asymptomatic and identified incidentally on cross-sectional imaging, aneurysm rupture presents significant morbidity. Ruptured pancreaticoduodenal arcade aneurysms typically present with abdominal pain, hemorrhagic shock, or gastrointestinal bleeding. A 72-year-old male presented with nausea and vomiting and was found to have imaging evidence of duodenal obstruction. This was due to a duodenal intramural hematoma caused by a ruptured submucosal aneurysm supplied by a branch of the inferior pancreaticoduodenal artery in the presence of median arcuate ligament compression of the celiac artery. This was subsequently treated with endovascular embolization with clinical improvement in duodenal obstruction. This case illustrates an unusual presentation of a ruptured pancreaticoduodenal arcade aneurysm. Keywords: Pancreaticoduodenal artery aneurysm, Duodenal stenosis, Duodenal obstruction
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- 2019
41. Inferior Pancreaticoduodenal Artery Aneurysm Related with Groove Pancreatitis Persistently Repeated Hemosuccus Pancreaticus Even After Coil Embolization
- Author
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Ryuhei Aoyama, Masahiro Yamada, Tomohide Hori, Michihiro Yamamoto, Hideki Harada, Takefumi Yazawa, Masazumi Zaima, Masaki Tani, Ryotaro Tani, Hidekazu Yamamoto, Yudai Sasaki, and Yasuyuki Kamada
- Subjects
Male ,medicine.medical_specialty ,Duodenum ,medicine.medical_treatment ,Fistula ,Aneurysm, Ruptured ,Radiology, Interventional ,030204 cardiovascular system & hematology ,Conservative Treatment ,Risk Assessment ,03 medical and health sciences ,0302 clinical medicine ,Aneurysm ,Pancreatitis, Chronic ,Hemosuccus pancreaticus ,medicine.artery ,medicine ,Humans ,Embolization ,Pancreas ,medicine.diagnostic_test ,business.industry ,Inferior pancreaticoduodenal artery ,Interventional radiology ,General Medicine ,Middle Aged ,medicine.disease ,Pancreaticoduodenectomy ,Embolization, Therapeutic ,Treatment Outcome ,030220 oncology & carcinogenesis ,Pancreatitis ,Radiology ,business ,Aortic Aneurysm, Abdominal ,Follow-Up Studies - Abstract
BACKGROUND Aneurysm of the inferior pancreaticoduodenal artery (IPDA) is rare among visceral artery aneurysms. Aneurysm and/or pancreatitis may have a causal relation with hemosuccus pancreaticus (HP). HP causes an obscure bleeding in the digestive tract, and this rare disease may lead to life-threatening condition. Although interventional radiology is generally employed as the initial treatment for visceral aneurysms, aneurysmic recanalization is a critical problem. CASE REPORT A 58-year-old male was incidentally diagnosed as groove pancreatitis, and his pancreatitis was successfully treated by conservative management. One year later, an IPDA aneurysm was detected in image studies. Gastrointestinal bleeding was objectively observed, and a diagnosis of asymptomatic HP was made. Arterio-pancreatic duct fistula was suspected, but was not identified. Coil embolization was successfully completed. Six months later, he suffered a relapse of HP, and visited our emergency unit. Pseudocystic lesion around metallic coils were confirmed. Subtotal stomach-preserving pancreaticoduodenectomy without any extended resections was performed. Intentional dissections of nerve plexuses and lymph nodes were all waived. Even a pancreatography of the resected specimen did not clarify his arterio-pancreatic duct fistula. He was discharged at postoperative day 10, and smoothly returned to his work. CONCLUSIONS Pancreatic juice-related complications after advanced pancreaticoduodenectomy for malignancies are often intractable. However, simple pancreaticoduodenectomy which omits extended resections and intentional dissections is safe and feasible for benign diseases. After the initial interventional radiology for pancreatic aneurysms, an elective pancreatic surgery should be considered to avoid unwanted recanalization and refractory HP.
- Published
- 2019
42. Successful Hemostasis of a Ruptured Inferior Pancreaticoduodenal Artery Aneurysm by Transcatheter Arterial Embolization
- Author
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Shinji Norimizu, Eiji Sakamoto, Noriaki Ohara, Syunichirou Komatsu, Kazuki Inaba, and Hiroshi Hasegawa
- Subjects
medicine.medical_specialty ,Aneurysm ,business.industry ,medicine.artery ,Arterial Embolization ,Hemostasis ,medicine ,Inferior pancreaticoduodenal artery ,medicine.disease ,business ,Surgery - Published
- 2019
43. Balloon-assisted coil embolization (BACE) of a wide-necked aneurysm of the inferior pancreaticoduodenal artery
- Author
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Modestino, Francesco, Cappelli, Alberta, Mosconi, Cristina, Peta, Giuliano, Bruno, Antonio, Vara, Giulio, De Benedictis, Caterina, and Golfieri, Rita
- Published
- 2020
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44. Inferior pancreaticoduodenal artery aneurysm rupture as a cause of haemoperitoneum – case report and review of the literature
- Author
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P Skalický, Starý L, J Tesaříková, V Prášil, Čestmír Neoral, K. Knapkova, Martin Lovecek, and Dušan Klos
- Subjects
medicine.medical_specialty ,Percutaneous ,medicine.medical_treatment ,Aneurysm, Ruptured ,Aneurysm ,Celiac Artery ,Mesenteric Artery, Superior ,Laparotomy ,medicine.artery ,medicine ,Humans ,Superior mesenteric artery ,Pancreas ,business.industry ,Inferior pancreaticoduodenal artery ,Middle Aged ,medicine.disease ,Collateral circulation ,Embolization, Therapeutic ,Surgery ,Stenosis ,Treatment Outcome ,Acute abdomen ,Hemoperitoneum ,medicine.symptom ,business - Abstract
Introduction: Arterial aneurysms of the pancreaticoduodenal arcade (PDA) represent approximately 2% of all aneurysms of visceral arteries. Despite a low incidence, this group of aneurysms is clinically significant due to its high risk of rupture. Case report: A 45 years old patient presented with a pancreaticoduodenal arcade aneurysm rupture along with a tight stenosis at the origin of the coeliac trunk. Retrograde blood flow from the superior mesenteric artery (SMA) to the hepatic artery (HA) via PDA limited our therapeutic options due to the necessity to maintain liver perfusion. The patient was indicated for an interventional radiology procedure, which consisted of percutaneous transluminal angioplasty (PTA) with stent placement at the origin of the coeliac trunk and subsequent transarterial embolisation (TAE) – trapping of the aneurysm using coils. Due to clinical signs of the intra-abdominal compartment syndrome, within 24 hours of the radiological treatment, the patient was indicated for surgical revision (laparotomy). During the surgery, no signs of active bleeding were found; coagula were evacuated from the abdominal cavity (800 ml) and laparostomy was performed with a temporary closure using a grid. Final closure of the abdominal cavity was performed on postoperative day 20 from the initial procedure. Follow-up abdominal CT performed 22 months after TAE showed no recurrence of the aneurysm. Conclusion: Aneurysm rupture represents a serious case of acute abdomen which requires urgent treatment. The preferred method of treatment for ruptured PDA aneurysms is the endovascular intervention using TAE, which is associated with lower morbidity and mortality than the surgical intervention. Concurrent coeliac trunk stenosis requires consideration given the need to maintain sufficient liver perfusion after TAE of the PDA aneurysm, acting up to this point as a collateral circulation of the liver. The choice of the therapeutic approach should be individualised taking into account the above mentioned recommendations.
- Published
- 2021
45. Controlling the arterial supply into the pancreatic head region as a whole peripancreatic arterial arcade via a mesenteric approach during isolated pancreatoduodenectomy
- Author
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Akimasa Nakao, Mitsuru Tashiro, Hironobu Kobayashi, Kiyotsugu Iede, Hironori Yamada, Kenji Oshima, Ryota Suzuki, and Yukiko Oshima
- Subjects
Adult ,Male ,medicine.medical_specialty ,Blood Loss, Surgical ,Dorsal pancreatic artery ,Collateral Circulation ,Computed tomography ,Pancreatic head ,Pancreaticoduodenectomy ,03 medical and health sciences ,0302 clinical medicine ,Blood loss ,medicine.artery ,Pancreatic cancer ,Multidetector Computed Tomography ,medicine ,Humans ,Pancreas ,Aged ,Retrospective Studies ,Aged, 80 and over ,Intraoperative Care ,medicine.diagnostic_test ,business.industry ,Arterial arcades ,Inferior pancreaticoduodenal artery ,General Medicine ,Middle Aged ,medicine.disease ,Independent factor ,Mesenteric Arteries ,Pancreatic Neoplasms ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Surgery ,Female ,Radiology ,business - Abstract
The peripancreatic arterial system forms various arterial arcades and collateral branches; therefore, it stands to reason that the arterial supply into the pancreatic head region should be controlled as a whole peripancreatic arterial arcade rather than as the three major supplying arteries during isolated pancreatoduodenectomy (PD). We investigated the clinical importance of early control of the whole peripancreatic arterial arcade during PD. The subjects of this retrospective study were 63 consecutive patients who underwent PD via a mesenteric approach at our hospital between October, 2014 and February, 2017. The patients were divided into an early control group (n = 27) and a late control group (n = 36) for comparative analysis. The peripancreatic arterial arcades and collateral branches were seen on preoperative multidetector row computed tomography (CT) images and during PD in all 63 patients. The early control group had significantly less intraoperative blood loss than the late control group. Early control of the whole peripancreatic arterial arcade was an independent factor associated with lower intraoperative blood loss in the multivariable analysis (P = 0.012). The arterial supply into the pancreatic head region should be controlled as a whole peripancreatic arterial arcade rather than as the three major supplying arteries during isolated PD.
- Published
- 2021
46. Aneurisma de artéria pancreatoduodenal inferior: tratamento endovascular
- Author
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Simone Lessa e Silva, Kamilla Rosales Costa, Alan Costa Gouveia, Fabricio Mascarenhas de Oliveira, Patrick Bastos Metzger, Ricardo F. Ferraz Melo, Murilo Quadro Berbert, and Milton Oliveira de Albuquerque Mello
- Subjects
medicine.medical_specialty ,procedimentos endovasculares ,RD1-811 ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Microcoil ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Aneurysm ,medicine.artery ,medicine ,Diseases of the circulatory (Cardiovascular) system ,Embolization ,aneurisma ,business.industry ,High mortality ,Clinical course ,Inferior pancreaticoduodenal artery ,medicine.disease ,Emergency situations ,embolização terapêutica ,Surgery ,RC666-701 ,Cardiology and Cardiovascular Medicine ,business ,Lower mortality - Abstract
Resumo Os aneurismas das artérias pancreatoduodenais constituem uma afecção rara. Seu diagnóstico é realizado, na maioria das vezes, em situações de emergência por complicações como a rotura, a qual está associada a altas taxas de mortalidade (21-26%). A embolização do saco aneurismático é o tratamento de escolha, devido à sua alta efetividade e menor mortalidade. Neste artigo, é apresentado e discutido um caso de aneurisma de artéria pancreatoduodenal inferior com diagnóstico obtido durante investigação de sintomas gastrointestinais. O tratamento instituído foi a embolização com micromolas, com completa exclusão do aneurisma e boa evolução clínica.
- Published
- 2021
47. Arteriovenous malformation in the pancreatic head initially mimicking a hypervascular mass treated with duodenum-preserving pancreatic head resection: a case report
- Author
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Minoru Nagayama, Ayumi Kanazawa, Yasutoshi Kimura, Tadashi Hasegawa, Masafumi Imamura, Takeshi Murakami, Shintaro Sugita, Hiroshi Yamaguchi, Takahiro Korai, Kotomi Terai, Daisuke Kyuno, Ichiro Takemasa, Ryo Miura, and Takayuki Nobuoka
- Subjects
medicine.medical_specialty ,Common bile duct ,Bile duct ,business.industry ,medicine.medical_treatment ,lcsh:Surgery ,Inferior pancreaticoduodenal artery ,Case Report ,lcsh:RD1-811 ,Pancreaticoduodenectomy ,Arteriovenous malformation ,Duodenum-preserving pancreatic head resection ,medicine.anatomical_structure ,medicine.artery ,Pancreatectomy ,medicine ,Duodenum ,Radiology ,Superior mesenteric vein ,Pancreas ,business - Abstract
Background The mainstay treatment for arteriovenous malformation in the pancreatic head (Ph-AVM) is standard pancreatectomy, especially pancreaticoduodenectomy (PD), or interventional endovascular treatment. We report the first case of Ph-AVM treated with duodenum-preserving pancreatic head resection (DPPHR) performed to preserve the periampullary organs. Case presentation A 59-year-old man presenting with back pain underwent contrast-enhanced computed tomography followed by angiography of the anterior superior pancreaticoduodenal artery. He was diagnosed with Ph-AVM and indicated for DPPHR with preservation of the periampullary organs; Ph-AVM’s benign nature seldom requires lymph node dissection. During the operation, the right colon was mobilized and the omental bursa was released to expose the periampullary structures. The pancreas was transected just above the superior mesenteric vein. The inferior pancreaticoduodenal artery and papillary arteries branching from the posterior superior pancreaticoduodenal artery were carefully preserved to maintain the blood flow to the lower bile duct and papilla of Vater. The remnant pancreas was reconstructed with pancreaticogastrostomy using the modified Blumgart method. Pathological examination of the resected specimen revealed an irregular course of the arteries and veins concomitant with marked dilation throughout the pancreatic head. The patient was pathologically diagnosed with Ph-AVM. He developed hematemesis caused by a rupture of the pseudoaneurysm on postoperative day 20 and underwent coil embolization. A bilio-enteric fistula and stenosis of the common bile duct were found and treated by placement of an endoscopic biliary stent. At the 8-month follow-up, the Ph-AVM had not recurred. Conclusions Compared to PD, DPPHR confers the clinical benefit of preserving the periampullary organs, although further studies are needed to confirm this. Therefore, the choice of this procedure should be based on the surgical morbidities and long-term outcome of the patient.
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- 2020
48. Superior perianastomotic fluid collection in the early postoperative period affects pseudoaneurysm occurrence after pancreaticoduodenectomy
- Author
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Takeru Maekawa, Toru Miyake, Katsushi Takebayashi, Hiroya Iida, Sachiko Kaida, Haruki Mori, Masaji Tani, Hiromitsu Maehira, Daiki Yasukawa, and Keiji Muramoto
- Subjects
medicine.medical_specialty ,Dorsal pancreatic artery ,030230 surgery ,Pancreaticoduodenectomy ,Gastroduodenal artery ,03 medical and health sciences ,Pseudoaneurysm ,Pancreatic Fistula ,0302 clinical medicine ,Hepatic Artery ,Postoperative Complications ,Falciform ligament ,Risk Factors ,medicine.artery ,medicine ,Humans ,Postoperative Period ,Computed tomography ,Retrospective Studies ,Perianastomotic fluid collection ,Common hepatic artery ,business.industry ,Pseudoaneurysm, pancreaticoduodenectomy ,Inferior pancreaticoduodenal artery ,Perioperative ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Pancreatic fistula ,030220 oncology & carcinogenesis ,business ,Aneurysm, False - Abstract
Purpose:Pseudoaneurysm (PA) after pancreaticoduodenectomy (PD) is a harmful complication due to postoperative pancreatic fistula. However, the preventive method for PA is unclear. This study aimed to assess the risk factors for PA after PD and to evaluate the clinical features of patients with PA., Methods:Medical records of 54 patients who underwent PD and developed clinically relevant postoperative pancreatic fistula (POPF) were retrospectively reviewed. We evaluated postoperative computed tomography (CT) findings, including the perianastomotic fluid collection (PFC) location on postoperative day 4. Perioperative findings and postoperative CT findings were compared between patients with and without PA after PD., Results:The PA group included nine patients (17%). The median postoperative day of diagnosis of PA was 17 (range, 7-33). The PA locations were the gastroduodenal artery stump (n = 3), dorsal pancreatic artery (DPA) stump from the common hepatic artery (n = 4), DPA stump from the replaced right hepatic artery (n = 1), and inferior pancreaticoduodenal artery stump (n = 1). The prevalence of falciform ligament wrap to the hepatic artery was lower (33% vs. 78%, p = 0.014) and superior PFC prevalence was higher (100% vs. 58%, p = 0.019) in the PA group than in the non-PA group. Superior PFC reached the dorsal part of the caudate lobe of the liver in all patients with PA. Furthermore, all PAs occurred at the arteries that could not be wrapped by the falciform ligament., Conclusion:Prevention of superior PFC and falciform ligament wrapping may reduce PA occurrence after PD with clinically relevant POPF.
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- 2020
49. Technical details of a left-side approach to the superior mesenteric artery during pancreaticoduodenectomy
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Takashi Matsui, Akihiro Takai, Mikiya Shine, Katsunori Sakamoto, Yasutsugu Takada, Seiji Matsuda, Yusuke Nishi, Hitoshi Inoue, Takeshi Utsunomiya, Kei Tamura, and Kohei Ogawa
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Male ,Duodenum ,medicine.medical_treatment ,030230 surgery ,Pancreaticoduodenectomy ,03 medical and health sciences ,0302 clinical medicine ,Cadaver ,Mesenteric Artery, Superior ,medicine.artery ,Medicine ,Humans ,Superior mesenteric artery ,Pancreas ,Aged ,business.industry ,Inferior pancreaticoduodenal artery ,Jejunal arteries ,General Medicine ,Anatomy ,SMA ,Pancreatic Neoplasms ,medicine.anatomical_structure ,Jejunum ,Treatment Outcome ,030220 oncology & carcinogenesis ,Surgery ,business ,Cadaveric spasm ,Artery - Abstract
To describe the procedure for a left-side approach to the superior mesenteric artery (SMA) during pancreaticoduodenectomy (PD) in a cadaveric study. After dividing the upper jejunum, the jejunal artery (JA) is followed to its origin. At the cranial side of the JA, the mesojejunum to be dissected is detached from the ventral to the dorsal side and from the peripheral to the origin side of the SMA. The inferior pancreatoduodenal artery (IPDA), which is usually the common trunk of the IPDA and the first JA, is able to be visualized at the cranio-dorsal side of the origin of the JA. After cutting the IPDA, the mesojejunum can be detached from the SMA from the dorsal aspect to the right side. Subsequently, the pancreas head is dissected easily from the right aspect of the SMA. This left-side approach to the SMA may become a standard procedure.
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- 2020
50. Bleeding Pseudoaneurysm of the Inferior Pancreaticoduodenal Artery as an Endoscopic Retrograde Cholangiopancreatography Complication
- Author
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Qi Yu, Weizheng Wang, Daniel Rim, and J. Cieslak
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medicine.medical_specialty ,Endoscopic retrograde cholangiopancreatography ,medicine.diagnostic_test ,business.industry ,Inferior pancreaticoduodenal artery ,Endoscopy ,General Medicine ,medicine.disease ,Surgery ,Pseudoaneurysm ,medicine.artery ,Image ,Medicine ,business ,Complication - Published
- 2020
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