Median arcuate ligament syndrome (MALS) involves narrowing of the celiac artery root from MAL compression, leading to pancreatoduodenal artery aneurysm (PDAA) due to increased retrograde blood flow from the superior mesenteric artery into the PDA. We encountered a case in which coil embolization was performed for PDAA rupture due to MALS. Four years later, a second PDAA occurred and ruptured, necessitating coil reembolization. There have been no reports of recurrence during long-term follow-up after PDAA treatment in patients with MALS. We herein report a rare case of metachronous PDAA rupture in the context of MALS. The relevant literature and 11 PDAA/MALS cases are discussed.
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http://dx.doi.org/10.2169/internalmedicine.3338-23 | DOI Listing |
Ann Surg Oncol
December 2024
Division of Hepato-Biliary-Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
Background: Pancreaticoduodenectomy (PD) is a complex procedure involving the dissection of the superior mesenteric artery and vein. However, a safe and standardized technique for dissecting the jejunal veins (JVs) in the mesojejunum during PD remains elusive.
Methods: We retrospectively analyzed 198 patients who underwent open PD with mesojejunum dissection using an anterior artery-first approach and evaluated anatomical variations in the first JV trunk (FJVT) and its tributaries.
Eur J Vasc Endovasc Surg
October 2024
Department of Angiology and Vascular Surgery, Centro Hospitalar Universitário de Santo António, Unidade Local de Saúde de Santo António, Porto, Portugal.
Ann Vasc Surg
January 2025
Vascular Surgery, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy; Vascular Surgery Unit, IRCCS Azienda Ospedaliero-Universitaria S. Orsola, Bologna, Italy.
Objectives: Few data are reported in literature about visceral artery aneurysms (VAAs) management. The aim of the present study was to analyze VAAs management in a single institution, with a dedicated algorithm for endovascular approach as the first line treatment.
Methods: A single-center retrospective cohort study was performed.
Ann Surg Oncol
December 2024
Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Background: Robotic pancreatoduodenectomy is an increasingly accepted alternative for the treatment of pancreatic ductal adenocarcinoma (PDAC). However, the ability to perform a meticulous robotic-assisted superior mesenteric artery (SMA) dissection to obtain a margin-negative resection remains unknown. PDAC within the head of the pancreas (HOP) that involves the superior mesenteric vein (SMV) and portal vein (PV) requires total venous control (TVC) and a 'vein-to-the-right' (or anterior artery-first) approach to SMA dissection to minimize venous congestion and operative blood loss.
View Article and Find Full Text PDFIntern Med
August 2024
Department of Gastroenterological Medicine, Kobe City Medical Center General Hospital, Japan.
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