ABSTRACT
Since the first report of an aneurysm involving the pancreaticoduodenal arteries a century ago, only 83 cases have been reported in our collective review of the English literature. Their presentation varies from indistinct abdominal pain to hemorrhagic shock, often making the diagnosis onerous. The mortality rate in this patient group has been significant, and in cases reported since 1980, the mortality rate remains at 17% (7 deaths/42 reported cases). Surgery has been, and continues to be, the cornerstone of therapy, with an incumbent mortality rate of 19% (5 deaths/26 patients treated surgically since 1980). This case report and 100-year review of the literature describes the causes, natural history, and historic management of pancreaticoduodenal artery aneurysms. Most importantly, it demonstrates the use of angiographic embolization in the definitive management of these aneurysms with no mortality.
Subject(s)
Aneurysm/therapy , Duodenum/blood supply , Embolization, Therapeutic , Pancreas/blood supply , Aneurysm/diagnostic imaging , Aneurysm/mortality , Angiography , Diagnosis, Differential , Humans , Male , Middle Aged , Survival Rate , Treatment OutcomeABSTRACT
Abdominal aortic aneurysms have been a rare finding in patients who have previously undergone renal transplantation. Previous operative strategies attempting to provide renal allograft protection during aortic cross-clamping have included extra-anatomic permanent as well as temporary bypass, heparin bonded shunts, in situ perfusion cooling of the allograft, and general hypothermia. These maneuvers, although generally successful, have recently been challenged by reports describing no specific protective measures. A case of a 5.0 cm but rapidly expanding abdominal aortic aneurysm in a patient who had undergone a prior successful kidney transplant is presented along with a literature review of 27 available cases on the subject.
