A Case of Ruptured Aneurysm of a Branch of the Posterior Superior Pancreaticoduodenal Artery

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  • 後上膵十二指腸動脈膵内分枝に発生した動脈瘤破裂の1例

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Abstract

We report a case of ruptured aneurysm of a branch of the posterior superior pancreaticoduodenal artery (PSPD). A 54-year-old woman was referred to our hospital because of sudden back pain. Enhanced computed tomography showed a retroperitoneal hematoma. Abdominal angiography showed an aneurysm, 8×8 in size, of a branch of the PSPD. We tried transcatheter embolization, however, could not reach the aneurysm due to difficulties in canulation. On the 7th day of hospitalization, we performed open laparotomy. We attempted to resect the aneurysm, but did not succeed because of the massive hematoma formation. To interrupt the blood flow, we carried out coiling embolization from the second jejunal artery and ligated the PSPD. On the 14th day of hospitalization, CT no longer showed the aneurysm. The patient was discharged on the 20th day of hospitalilzation. We consider that our method would be useful for the treatment of a ruptured aneurysm when direct treatment by IVR or operation cannot be undertaken.

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