An Operated Case of Massive Gastrointestinal Bleeding due to Ruptured Aneurysm of the Pancreaticoduodenal Artery Associated with Multiple Visceral Artery Aneurysms and Dissecting Aortic Aneurysm

Toshio Nakamura, Makoto Yagi, Takeshi Kuhara, Emiko Kojima, Toshikatsu Taniki, Yasuo Fukui, Takahiro Yoshida and Takashi Yamakawa*

Department of Surgery and Department of Breast and Thyroid Surgery*, Kochi Municipal Hospital

A 76-year-old female was referred and admitted to our hospital with the complaint of abdominal and back pain. Multiple visceral artery aneurysms and dissecting aortic aneurysm were detected by abdominal CT and angiography. Suddenly, she developed massive gastrointestinal bleeding with shock at 35 hospital days. Emergency operation was performed to her. Aneurysm of the pancreaticoduodenal artery ruptured into the duodenum. Hemostasis accomplished with ligation and suturing of the anterior pancreaticoduodenal arteries, closure of the duodenal wall, and filling up the cavity of aneurysm by the major omentum. Postoperative courses were uneventful.

Key words
visceral artery aneurysm, dissecting aortic aneurysm, segmental arterial mediolysis

Reprint requests
Toshio Nakamura Department of Surgery, Kochi Municipal Hospital
1-7-45 Marunouchi, Kochi, 780-0850 JAPAN

Accepted
June 25, 2003

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