Abstract
Pancreaticoduodenal artery (PDAA) aneurysms are an extremely rare visceral artery aneurysm (VAA) subtype, usually managed by endovascular techniques. We report a 57-year-old man with an intrapancreatic, inferior PDAA (IPDAA) abutting the superior mesenteric artery (SMA). This location, in relation to the SMA, risks SMA thrombosis in an endovascular only approach. Our approach consisted of open exploration and ligation of IPDAA junction at SMA, followed by endovascular coil embolization of the aneurysm. This case serves as a reminder that although many vascular diseases can be treated with less invasive endovascular strategies, open surgery can sometimes be the safer alternative.
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