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- W4387248636 abstract "SESSION TITLE: Critical Care Case Report Posters 10 SESSION TYPE: Case Report Posters PRESENTED ON: 10/09/2023 12:00 pm - 12:45 pm INTRODUCTION: Arterial aneurysms of the pancreaticoduodenal artery (PDA) represent less than 2% of all aneurysms of visceral arteries. Despite a low incidence, this entity carries high mortality. CASE PRESENTATION: 57 year old woman with no significant history presented with nausea, vomiting, diarrhea for 36 hours associated with severe abdominal pain and cramping. Patient was initially hypertensive but quickly became tachycardic and hypotensive. Initial labs remarkable for elevated lactic acid, which prompted imaging. Computed tomography of abdomen and pelvis was significant for retroperitoneal hematoma displacing pancreas and duodenum, and extending into pelvis. Near complete occlusion of the celiac trunk was found, with prominent tortuous pancreaticoduodenal collateral channels. Abdominal angiography confirmed ruptured inferior PDA aneurysm. Patient was successfully managed with primary endovascular repair and blood products. DISCUSSION: This case illustrates life threating etiology that presented with frequently seen chief complaints. PDA aneurysm are associated with celiac trunk stenosis (CTS) in 68–74% of cases, and carry significant risk of rupture. Mortality rates with rupture ranges from 12% to 50%. The preferred method of treatment for ruptured PDA aneurysms is the endovascular intervention. CTS requires consideration given the need to maintain sufficient liver perfusion as collateral channels act as collateral circulation of the liver. CONCLUSIONS: Management of the CTS remains controversial. REFERENCE #1: Skalický P, Loveček M, Klos D, Neoral Č, Prášil V, Starý L, Knápková K, Tesaříková J. Inferior pancreaticoduodenal artery aneurysm rupture as a cause of haemoperitoneum - case report and review of the literature. Rozhl Chir. 2021 Winter;100(1):32-36. English. doi: 10.33699/PIS.2021.100.1.32-36. PMID: 33691421. REFERENCE #2: Zhang X, Zhang W, Zhou W, Zhou W. Endovascular Treatment of Ruptured Pancreaticoduodenal Artery Aneurysm with Celiac Axis Stenosis. Ann Vasc Surg. 2019 May;57:273.e1-273.e5. doi: 10.1016/j.avsg.2018.09.033. Epub 2019 Jan 24. PMID: 30684620. REFERENCE #3: Corey MR, Ergul EA, Cambria RP, Patel VI, Lancaster RT, Kwolek CJ, Conrad MF. The presentation and management of aneurysms of the pancreaticoduodenal arcade. J Vasc Surg. 2016 Dec;64(6):1734-1740. doi: 10.1016/j.jvs.2016.05.067. PMID: 27871496. DISCLOSURES: No relevant relationships by Vesna Buntak No relevant relationships by Jeff Kwon No relevant relationships by Ariane Loutoo" @default.
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- W4387248636 date "2023-10-01" @default.
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- W4387248636 title "A COMMON CHIEF COMPLAINT WITH AN UNCOMMON ETIOLOGY" @default.
- W4387248636 doi "https://doi.org/10.1016/j.chest.2023.07.1308" @default.
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