Pancreaticoduodenal artery aneurysm: Treatment outcomes of a rare disorder

Abstract

Objective: Pancreaticoduodenal artery aneurysm is a rare vascular disorder that manifests with a clinical presentation ranging from asymptomatic cases to hemorrhagic shock due to aneurysm rupture. In this study, we aimed to evaluate the outcomes of patients treated with different methods for pancreaticoduodenal artery aneurysm. Material and Methods: A total of 5 patients who were treated and followed for pancreaticoduodenal artery aneurysm between January 2011 and January 2018 were enrolled in the study. Standard endovascular embolization and surgical resection were performed. The demographic findings and treatment outcomes were compared. Results: All patients were shown to have a pancreaticoduodenal artery aneurysm by radiological methods. The most common complaint was abdominal pain. The mean aneurysm size was 2.8 cm. Two patients had coeliac axis stenosis and occlusion, one had hypertension, one had Marfan syndrome, and one had chronic pancreatitis as the possible etiological cause. One patient with occlusion of the coeliac axis had thrombus, one patient with coeliac axis stenosis had median arcuate ligament compression. Three patients were treated with embolization, one with surgery, and one with low-molecular weight heparin. Conclusion: Different etiological factors and multiple vascular problems accompanying the disorder create difficulties for establishing a treatment algorithm. Due to the rare nature of the disease, studies available in the literature involve limited numbers of patients, as was also the case in our study. There appeared to be no significant differences between the treatment and follow-up duration among the different treatment methods we applied for our patients.