Multiple visceral artery aneurysms are relatively rare; the rarest are
superior mesenteric artery and gastroduodenal artery aneurysms. The clinical
presentation depends on the size and site of the aneurysm. We report the case
of a 33-year-old man with recurrent episodes of obstructive jaundice and weight
loss. Computed tomography with contrast revealed scattered hepatic arterial
aneurysms with two other aneurysms along the course of the left gastro-duodenal and superior
mesenteric artery. Investigations to determine the etiology were negative, but
the patient had a history of smoking and substance abuse. Angiography revealed an occluded feeding artery.
The patient developed multiorgan failure, leading to cardiac arrest and
died. Diagnosing multiple visceral artery aneurysms needs a high index of
suspicion; early diagnosis enables early intervention, which can reduce the
high mortality of this condition.
References
[1]
Sumpio, B., Eidt, J.F., Mills, S.R., et al. (2019) Overview of Visceral Artery Aneurysm and Pseudoaneurysm. Uptodate.
[2]
Shawky, M.S., Tan, J. and French, R. (2015) Gastroduodenal Artery Aneurysm: A Case Report and Concise Review of Literature. Annals of Vascular Diseases, 8, 331-333. https://doi.org/10.3400/avd.cr.15-00086
[3]
Trajbar, T., Pavic, P., Ivkosic, et al. (2006) A Rare Case of Multiple Aneurysms in a Young Patient. Collegium Antropologicum, 30, 235-238.
[4]
Naha, K., Vivek, G., Shetty, R.K. and Dias, L.S. (2013) Multiple Idiopathic Arterial Aneurysms Masquerading as Aortic Dissection. BMJ Case Reports. https://doi.org/10.1136/bcr-2012-008030
[5]
De Silva, W.S.L., Gamlaksha, D.S., Jayasekara, D.P. and Rajamanthri, S.D. (2017) A Splenic Artery Aneurysm Presenting with Multiple Episodes of Upper Gastrointestinal Bleeding: A Case Report. Journal of Medical Case Reports, 11, 123. https://doi.org/10.1186/s13256-017-1282-7
[6]
Konstantakos, A.K., Coogan, S.M., Husni, E.A., et al. (2000) Aneurysm of the Gastroduodenal Artery: An Unusual Cause of Obstructive Jaundice. The American Surgeon, 66, 695-698.
[7]
Ibrahim, F., Dunn, J., Rundback, J., Pellerito, J. and Galmer, A. (2018) Visceral Artery Aneurysms: Diagnosis, Surveillance, and Treatment. Current Treatment Options in Cardiovascular Medicine, 20, 97. https://doi.org/10.1007/s11936-018-0696-x
[8]
Barkun, A.N., et al. (2010) International Consensus Recommendations on the Management of Patients with Nonvariceal Upper Gastrointestinal Bleeding. Annals of Internal Medicine, 152, 101-113. https://doi.org/10.7326/0003-4819-152-2-201001190-00009
[9]
Chue, M.W., Venkatanarasimha, N. and Damodharan, K. (2017) Ischemic Pancreatitis: A Rare Complication of Empirical Gastroduodenal Artery Embolization. Indian Journal of Radiology and Imaging, 27, 338-341. https://doi.org/10.4103/0971-3026.215571
