A Case of Congenital Agenesis of Celiac Artety and Superior Mesenteric Artery Complicated with Penetrating Gastric Ulcer

Shin-ichiro Aoki, Atsushi Kimura, Yasushi Adachi, Hiroshi Adachi, Shigetoyo Saji*

Department of Surgery, Adachi Hospital
*Second Department of Surgery, Gifu University School of Medicine

We report the first case in Japan of an unusual arterial malformation, congenital agenesis of the celiac artery and superior mesenteric artery. The diagnosis in this case was made preoperatively by abdominal angiography and confirmed surgically. A 45-year-old male with a history of Moyamoya disease underwent distal partial gastrectomy for a penetrating gastric ulcer. Angiographic and operative findings showed that the inferior mesenteric artery fed the greater curvature of the stomach, the entire small intestine and colon, and probably the pancreas and spleen. The liver was fed only by several arteris around the ligament teres hepatis. We concluded that in this case the celiac artery and superior mesenteric artery were somehow closed at the base in utero, and collateral pathways developed from the inferior mesenteric artery.

Key words
congenital agenesis of celiac artery and superior mesenteric artery, penetrating gastric ulcer

Reprint requests
Shin-ichiro Aoki Department of Surgery, Adachi Hospital
696-2 Arise, Ikawadani-cho, Nishi-ku, Kobe, 651-21 JAPAN

Accepted
December 6, 1995

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