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내혈관 및 내시경적 방법으로 치료한 췌장염을 동반한 췌십이지장동맥류 파열

Ruptured Pancreaticoduodenal Artery Aneurysm with Pancreatitis Treated Using Endovascular and Endoscopic Methods

대한소화기학회지 2021년 77권 4호 p.194 ~ 198
Park Chan, 박동은,
소속 상세정보
 ( Park Chan ) - Wonkwang University School of Medicine Department of Surgery
박동은 ( Park Dong-Eun ) - Wonkwang University College of Medicine Department of Surgery

Abstract


Pancreaticoduodenal artery aneurysm (PDAA) is a rare form of abdominal visceral aneurysm that accounts for approximately 2% of all cases. Most cases of PDAA are associated with celiac artery stenosis (CAS). Regardless of the size, there is a risk of rupture. Therefore, treatment should be performed immediately after discovery, even though the need to treat the accompanying CAS, if present, is controversial. The authors report a case of ruptured PDAA and accompanying pancreatitis treated using endovascular and endoscopic methods without treatment of CAS. A 50-year-old man was admitted to the emergency department of Wonkwang University Hospital with epigastric pain and hypovolemic shock. CT revealed a ruptured PDAA and a large volume hemoperitoneum. Emergency angiography was performed, and angioembolization of the PDAA was performed successfully. Follow-up CT revealed infection and pancreatitis, which were treated by surgical drainage and pancreatic duct stenting with ERCP. Because the degree of stenosis was not severe, it was decided to follow-up the accompanying CAS. After discharge, the patient was followed up without complications.

키워드

Median arcuate ligament syndrome; Hemoperitoneum; Aneurysm; ruptured

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