PMC4729323_01
CT scan showing (A) fluid collection in the both the subphrenic and retroperitoneal spaces and (B, C) a pancreaticoduodenal artery aneurysm (yellow circle).
amjcaserep-17-39-g001.jpg
PMC4729323_01_amjcaserep-17-39-g001.jpg
f1-amjcaserep-17-39
In addition, the CT suggested an aneurysm arising from a branch of the superior mesenteric artery (SMA) (Figure 1A-1C).
Superior mesenteric arteriography showing (A) a pancreaticoduodenal artery aneurysm (arrow) and (B) bleeding from the aneurysm (arrow).
amjcaserep-17-39-g002.jpg
PMC4729323_01_amjcaserep-17-39-g002.jpg
f2-amjcaserep-17-39
Urgent selective SMA angiography demonstrated an aneurysm on the arch comprising the superior and inferior PDA (pancreatic arch) with signs of hemorrhage (Figure 2A, 2B).
(A) Intraoperative photography of the aneurysm (yellow arrow). PIPDA; posterior inferior pancreaticoduodenal artery. SMA - superior mesenteric artery. SMV - superior mesenteric vein. (B) A photograph of the resected aneurysm.
amjcaserep-17-39-g003.jpg
PMC4729323_01_amjcaserep-17-39-g003.jpg
f3-amjcaserep-17-39
The feeding arteries were easily exposed under CDUS guidance and were ligated with minimum operative blood loss (Figure 3A), and then the aneurysm was resected (Figure 3B).