Rupture of a Rare Celiomesenteric Trunk Aneurysm following Mechanical Fall

Abstract

A celiomesenteric trunk (CMT) is an anatomical variation involving a common origin of the celiac trunk (CT) and the superior mesenteric artery (SMA). The prevalence of a celiomesenteric trunk anatomic variation has been found to be in the region of 3.4% but the incidence of aneurysms in this particular visceral artery are unknown [1]. There are only 20 cases of a celiomesenteric anomaly with an associated aneurysm documented in the last 35 years [2]. This article describes the emergency management of such an aneurysm in a frail 65-year-old female who knew about her aneurysm and was considering a recommendation for elective repair. On this occasion, the aneurysm ruptured (see figure 1) after a mechanical fall down some stairs at home. This difficult case was successfully managed with open repair and a 6mm Dacron interposition graft was sutured end-to-end with continuous 6/0 prolene from the SMA-CT common origin to the bifurcation into Splenic Artery and Common Hepatic Artery. She was discharged on post-operative day four. At her two month follow up appointment she had made an impressive recovery with no complications.