Pancreaticoduodenal Arcade Aneurysms

Lateral view of a superior mesenteric artery angiogram. Note the multiple branches of the pancreaticoduodenal arcade. Each branch is hypertrophied and has an approximately 1 cm true aneurysm (arrows). The celiac axis is occluded secondary to compression by the median arcuate liagament of the diaphragm (Celiac Artery Compression Syndrome). With the celiac branches occluded the arterial supply to the liver and spleen came from collaterals formed from the inferior branches of the pancreaticoduoenal arcade. With the increased blood flow, the branches hypertrophied and formed aneurysms.

This patient presented clinically, with peritoneal hemorrhage from a leak in one of the aneurysms. The patient was treated with surgical revascularization of the celiac branches and endovascular embolization of the aneurysms.