Published online Apr 28, 2016. doi: 10.3748/wjg.v22.i16.4259
Peer-review started: December 4, 2015
First decision: December 31, 2015
Revised: January 27, 2016
Accepted: February 20, 2016
Article in press: February 22, 2016
Published online: April 28, 2016
Processing time: 138 Days and 11.5 Hours
Pancreaticoduodenal artery aneurysms are a rare type of visceral artery aneurysm, whose rupture is associated with high mortality. These aneurysms are of particular interest because local haemodynamic change caused by coeliac artery obstruction plays an important role in their development. However, the pathophysiological mechanism of coeliac artery obstruction is not completely understood. Pressure from the median arcuate ligament is most frequently reported cause. Although it is well-known that stenosis or occlusion of the visceral vessels may be caused by aortic syndrome, reports of pancreaticoduodenal artery aneurysm associated with coeliac artery occlusion due to aortic syndrome are extremely rare. Our case indicates a new aetiology for a pancreaticoduodenal artery aneurysm and demonstrates the rapid deterioration of the patient affected.
Core tip: Approximately 60% of patients with pancreaticoduodenal artery aneurysms presented with rupture have an attending mortality rate of 50%. With the development of the device and techniques, transcatheter arterial embolotherapy has decreased the mortality to as low as 0%. Therefore, early detection and treatment is necessary to improve prognosis of the case.