However, an indentation with severe stenosis was noted in the proximal celiac trunk, and the inferior pancreaticoduodenal artery
(PDA) was dilated, possibly as a compensatory supply to the celiac territory via the gastroduodenal artery (Figure 2).
Celiac trunk stenosis with contrast extravasation of contrast material from the ruptured aneurysm arising in the anterior inferior pancreaticoduodenal artery was found.
Inferior pancreaticoduodenal artery aneurysms associated with occlusive lesions of the celiac axis: diagnosis, treatment options, outcomes, and review of the literature.
In a review of 98 cases of hemorrhage from pancreatic pseudocysts and pseudoaneurysms from an identifiable bleeding vessel in the setting of pancreatitis, 45% arose from the splenic artery, 17% from the gastroduodenal artery, 11% from the inferior pancreaticoduodenal artery
(IPDA), 5% from the superior pancreaticoduodenal artery, and 22% from other vessels .
Abbreviations PDA: Pancreaticoduodenal artery IPDA: Inferior pancreaticoduodenal artery TAE: Transarterial embolization SMA: Superior mesenteric artery PTI: Percutaneous thrombin injection.
Ikoma, "Inferior pancreaticoduodenal artery aneurysm treated with coil packing and stent placement," World Journal of Radiology, vol.
Stanson, "Management of inferior pancreaticoduodenal artery aneurysms: a 4-year, single center experience," Cardio-Vascular and Interventional Radiology, vol.
Eskandari, "Coil embolization of an inferior pancreaticoduodenal artery
aneurysm associated with celiac artery occlusion," Cardiovascular Surgery, vol.
In this setting, early ligation of the inferior pancreaticoduodenal artery (feeding the bleeding pancreatic head pseudoaneurysm) enabled a steady hemostasis and removal of the lesion.
Moreover, there is a reduced intraoperative blood loss, due to an early ligation of the inferior pancreaticoduodenal artery [20, 40].
This patient had blunt abdominal trauma and presented with a large pseudoaneurysm filling from the inferior pancreaticoduodenal artery
. After selective catheterization of the superior mesenteric artery multiple collateral vessels was seen at the origin of inferior pancreaticoduodenal artery
with retrograde filling of gastroduodenal artery.
According to Vimalaraj et al., in a case series of 31 HP patients, they had identified the bleeding source arising from the splenic artery (n = 17), gastroduodenal artery (n = 5), superior pancreaticoduodenal artery (n = 1), inferior pancreaticoduodenal artery
(n = 2) and from the superior mesenteric artery (n = 1).