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Published on October 15, 2009
Interactive CardioVascular and Thoracic Surgery 2009, doi:10.1510/icvts.2009.219949
© 2009 European Association of Cardio-Thoracic Surgery

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Aortic and aneurysmal (ICVTS only)

Aorto-gastroduodenal bypass grafting for an inferior pancreaticoduodenal aneurysm and celiac trunk thrombosis

Jens C. Ritter 1*, Malcolm Johnston 2, Mario F. Caruana 2, Peter E. Laws 2

1 University of South Manchester, UK
2 Worthing Hospital, West Sussex, UK

* To whom correspondence should be addressed. E-mail: jc.ritter{at}web.de.


   Abstract
We present a case of a male patient diagnosed with a large inferior pancreaticoduodenal artery (IPDA) aneurysm, associated with a fresh thrombotic occlusion of the celiac trunk. Given the risk of splanchnic ischaemia, radiologic embolisation of the aneurysm combined with celiac axis stenting was deemed unsafe. Management was therefore modified to elective revascularisation of the celiac axis prior to surgical resection of the aneurysm. A retropancreatic aorto-gastroduodenal artery bypass graft was performed prior to exposing and resecting the pancreaticoduodenal artery aneurysm. This ensured near uninterrupted retrograde supply to the celiac axis during the procedure. This is an effective, efficient and expeditious patient pathway for these rare and complex aneurysms complicated by celiac trunk involvement. Keywords: Aneurysm; Celiac artery; Splanchnic circulation





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