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Inferior pancreaticoduodenal artery aneurysms in association with celiac axis stenosis or occlusion.
The uncoincidental relationship between PAAAs and celiac axis stenosis/occlusion is well known and was first described by Sutton and Lawton in 1973.
To the best of our knowledge, this is the largest group of PAAA aneurysm cases associated with celiac axis lesions.
On careful observation, we observed that the celiac axis had four branches: (a) left gastric artery, (b) common hepatic artery, (c) splenic artery and (d) an aberrant branch, which took a course inferiorly towards the pancreas ('A' in Fig.1).
It entered the root of the mesentery 1cm from its origin, 5 mm inferior to the origin of the celiac axis. The duodenum, pancreas and the inferior layer of the transverse mesocolon had the root of the mesentery attached to them.
The pancreaticoduodenal artery is the main collateral pathway between the celiac axis and the superior mesenteric artery.
(1966), several authors reported the celiac plexus compression by both agents--the median arcuate ligament and the celiac axis (Rob, 1966; Stoney & Wylie; Bobbio et al.; Harjola & Lahtiharju, 1968; Tahery (1968); Carey et al.; Cormier & De La Fontaine, 1970; Olivier et al., 1970; Balmes et al., 1971; Lindner & Kemprud, 1971; Stanley & Fry; Tongio et al., 1971; Dreze et al.; Conti et al.; Beger et al., 1975; Joubaud et al.; Watson & Sadikali, 1977; Guibert et al., 1980; Daskalakis, 1982; Ghosn et al., 1982; Matesanz et al., 1982; Thevenet et al., 1985; Bacourt et al., 1984 and Roayaie et al.).
The syndrome of celiac trunk compression (or celiac axis compression syndrome) is a nosologic entity that has been recently introduced in the abdominal vascular pathology field based on the clinical-radiological observations by correlating abdominal symptoms caused by the compression of celiac trunk crura (Dunbar et al., 1965).
After exposure of the celiac axis, we analyzed the possible emission of inferior phrenic arteries from this vessel as well as site of origin.