ABSTRACT
We present the case of a 48-year-old male who presented to the emergency department with left-sided abdominal pain of four-day duration. The pain was described as sharp in nature and was located in the left lower quadrant with radiation to the left shoulder. A computerized tomography (CT) scan of the abdomen and pelvis without contrast showed celiac artery enlargement with adjacent inflammatory stranding. There were other chronic findings secondary to prior surgery. A CT angiogram of the abdomen and pelvis was performed, which showed a 10 x 5 mm saccular pseudoaneurysm at the posterior aspect of the celiac trunk with surrounding inflammatory changes. Endovascular repair was accomplished in the operating room after the placement of the stent graft. Repeat angiogram showed successful exclusion of the aneurysm, with excellent perfusion to the arteries distal to the site of repair. The patient was successfully discharged two days later with outpatient follow-up. Celiac artery aneurysms can present to the emergency department with abdominal pain. The detection of celiac artery aneurysms may be increasing due to increased detection on CT scans. Although rare, this type of visceral artery aneurysm carries a high mortality rate if ruptured. Surgical repair may be either through an endovascular approach or through open surgical repair of the aneurysm preferably with prosthetic grafts.
