Work

Acute development and rupture of a pancreaticoduodenal artery aneurysm after endovascular aneurysm repair in a patient with median arcuate ligament syndrome

Year: 2026

Type: article

Abstract: An 80-year-old man underwent endovascular aneurysm repair at our institution. Preoperative imaging demonstrated celiac artery occlusion caused by median arcuate ligament syndrome and markedly developed pancreaticoduodenal arcades; however, a pancreaticoduodenal artery (PDA) aneurysm (PDAA) was not identified. On postoperative day 2, contrast-enhanced computed tomography (CT) showed no aneurysm, hematoma, or vascular injury involving the arcade vessels. On postoperative day 3, sudden abdominal pain developed. Contrast-enhanced CT revealed a retroperitoneal hematoma with active extravasation, and emergency angiography demonstrated a newly formed ruptured 4-mm aneurysm of the anterior inferior PDA. Coil embolization was successfully performed. This case demonstrates that PDAAs may form and rupture rapidly. Clinicians should explore this rare but potentially fatal condition even when recent imaging studies show no evidence of aneurysm formation.

Source: Radiology Case Reports

DOI: 10.1016/j.radcr.2026.03.036

Authors: Ayumi Ito, Gaku Matsumoto, Fumiaki Iwase

Institution: Yamanashi Prefectural Central Hospital

Language: English

Topic: Abdominal vascular conditions and treatments

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $600