CASE REPORT OF POSTEROINFERIOR PANCREATICODUODENAL ARTERY ANEURYSM WITH A DEFICIENCY OF THE COMMON HEPATIC ARTERY

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A case of posteroinferior pancreaticoduodenal artery aneurysm with a deficiency of the common hepatic artery is reported. A 72-year-old woman was admitted to the hospital because of lumbago. Abdominal simple X-ray film demonstrated two pieces of signet-ring calcification in the upper abdominal region and laboratory data showed increased serum level of CA19-9. A pancreatic tumor was suspected. Celiac angiogram demonstrated that a deficiency of the common hepatic artery was present and blood flow of he proper hepatic artery was supplied by left and right gastric artery arcades. The origin of the superior mesenteric artery was obstructed. An aneurysm was found to be located on collateral artery of the posteroinferior pancreaticoduodenal artery. After a diagnosis of posteroinferior pancreaticoduodenal arterial aneurysm was made, an operation was performed. An aneurysmectomy was carried out and great saphenous vein graft was used to replace the posteroinferior pancreaticoduodenal arterial aneurysm, which extended from the aortic artery to superior mesenteric artery. This aneurysm was attributed to arteriosclerosis. The postoperative course was uneventful, and serum level of CA19-9 decreased within normal limits. The patient has been well as of 5 years after the operation.
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