A case of a pancreaticoduodenal artery aneurysm presented with obstructive jaundice

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  • 閉塞性黄疸で発症した膵十二指腸動脈瘤の1例
  • 症例 閉塞性黄疸で発症した膵十二指腸動脈瘤の1例
  • ショウレイ ヘイソクセイ オウダン デ ハッショウ シタ スイジュウニシチョウ ドウミャクリュウ ノ 1レイ

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Abstract

We have experienced a case of a pancreaticoduodenal artery aneurysm presented with obstructive jaundice. There has been only one case report of a surgically treated pancreaticoduodenal artery aneurysm associated with jaundice, as far as we could review. The case involved a 62-year-old man who was seen at the hospital because of abdominal pain and jaundice. Blood examinations showed the elevated serum level of total bilirubin, 7.9 mg/dl. MRCP and ERC revealed narrowing of the lower bile duct due to extramural pressure. Dynamic CT scan showed an about 4 × 3 cm tumorous lesion with strong enhancement effect. Obstructive jaundice caused by a pancreaticoduodenal artery aneurysm was diagnosed by 3D CT angiography. Firstly coil embolization was attempted, but the cannulation was unsuccessful due to the tortuous course of the pancreaticoduodenal artery. The patient was considered to be a candidate for surgery. Following sufficient review and discussion of imaging findings, we started surgery. However, we could not have grasped all vessels inflowing in the aneurysm, for that we had great difficulties in performing surgery. We had to change the operative procedure, from aneurysmotomy which was planned before surgery to aneurysmectomy.<BR>Intra-abdominal visceral vessels pursue complicated courses. We must have an accurate grasp of the courses of these vessels by making full use of imaging procedures not only before but also during surgery for intraabdominal visceral artery aneurysms.

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