Alam Walid, Kamareddine Mohammed Hussein, Geahchan Amine, Ghosn Youssef, Feghaly Michel, Chamseddine Abbas, Bou Khalil Rola, Farhat Said
Department of Internal Medicine, Saint George Hospital University Medical Center, Beirut, Lebanon.
Saint George Hospital University Medical Center, Beirut, Lebanon.
SAGE Open Med Case Rep. 2020 Aug 6;8:2050313X20938243. doi: 10.1177/2050313X20938243. eCollection 2020.
In rare cases, the celiac artery and the superior mesenteric artery arise from a common origin known as a common celiacomesenteric trunk. Celiac trunk stenosis or occlusion has been reported to accompany this anatomical aberrancy. Even rarer, are aneurysms associated with this common celiacomesenteric trunk. In general, visceral artery aneurysms are uncommon. We hereby present a 39-year-old female patient with a 1-month history of mild diffuse abdominal pain, with an incidental finding of superior mesenteric artery aneurysm on abdominal ultrasound. Subsequent contrast-enhanced computed tomography revealed severe narrowing of the celiac trunk and saccular aneurysmal dilatation of the superior mesenteric artery. Coil embolization of the aneurysm was performed, while maintaining persistent flow in the superior mesenteric artery and celiacomesenteric trunk. Visceral artery aneurysms are increasingly being identified incidentally with improvement in imaging techniques. The question lies whether to treat these aneurysms or observe. No universal guidelines exist regarding that matter, but the decision to intervene is made based on aneurysm location, size, and patient characteristics.
在罕见情况下，腹腔干和肠系膜上动脉起源于一个共同的起始部位，称为腹腔肠系膜干。据报道，腹腔干狭窄或闭塞常伴有这种解剖变异。更罕见的是，与这种腹腔肠系膜干相关的动脉瘤。一般来说，内脏动脉瘤并不常见。我们在此报告一名39岁女性患者，有1个月轻度弥漫性腹痛病史，腹部超声偶然发现肠系膜上动脉瘤。随后的增强CT显示腹腔干严重狭窄，肠系膜上动脉呈囊状动脉瘤样扩张。对动脉瘤进行了弹簧圈栓塞，同时保持肠系膜上动脉和腹腔肠系膜干的持续血流。随着成像技术的改进，内脏动脉瘤越来越多地被偶然发现。问题在于是否治疗这些动脉瘤还是进行观察。关于此事尚无通用指南，但干预决策是根据动脉瘤的位置、大小和患者特征做出的。
