What is a celiac artery aneurysm?

What is a celiac artery aneurysm?

1. Celiac artery aneurysm refers to an aneurysm occurring at the distal end of the celiac artery. It accounts for 4% of all visceral artery aneurysms in the body and mostly occurs in middle-aged and older people. Currently, the incidence rate of men and women tends to be equal.

2. The common cause of celiac artery aneurysm is medial degeneration accompanied by arteriosclerosis, followed by traumatic infection and congenital factors. Syphilis has also been reported occasionally.

3. Most cases of celiac artery aneurysms are asymptomatic, but a few may present with upper abdominal pain and discomfort radiating to the back, which is often mistaken for pancreatitis or peptic ulcer disease. The symptoms of celiac artery aneurysms are similar to those of peptic ulcer disease. Even after partial gastrectomy, the abdominal pain is not relieved and the pain is relieved only after the aneurysm is removed. Rupture of the aneurysm causes bleeding in the celiac trunk, first into the lesser omental sac and then into the peritoneal cavity. At this time, upper abdominal pain and back pain accompanied by nausea and vomiting may occur.

4. Upper abdominal pain, pulsating mass, gastrointestinal bleeding, shock and occasionally obstructive jaundice are often manifestations of ruptured celiac artery aneurysm.

Treatment:

1. Surgical approach: For ruptured or threatened ruptured celiac artery aneurysms, a good surgical field can be obtained by a combined thoracoabdominal incision from the left anterior axillary line through the seventh intercostal space, followed by a midline incision of the abdomen after thoracotomy. For most non-ruptured celiac artery aneurysms, transabdominal resection can be performed.

2. Surgical method: It mainly depends on the size and location of the aneurysm. If the proximal and distal blood vessels are normal and have sufficient length after aneurysm resection, direct end-to-end anastomosis can be performed; if the length is not enough, after the aneurysm is resected, the abdominal aorta-abdominal artery interposition transplantation can be used to reconstruct the blood vessels using autologous great saphenous vein or artificial blood vessels. According to literature reports, more than 35% of patients can undergo aneurysm resection and celiac trunk ligation without causing liver necrosis. Abdominal aneurysms often compress the splenic vein. Clinical signs of portal hypertension and highly distended splenic veins should be noted.