Please wait a minute...
J Zhejiang Univ (Med Sci)  2018, Vol. 47 Issue (6): 601-605    DOI: 10.3785/j.issn.1008-9292.2018.12.06
    
One case of hepatosplenic artery aneurysm with hepato-splenomesenteric trunk and literature review
SHEN Yang(),ZHANG Ruili,CHEN Guang,LI Fei,CHU Haiwei,HU Bin,ZHAO Wenjun*()
Department of Vascular Surgery, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Taizhou 317000, Zhejiang Province, China
Download: HTML( 3 )   PDF(1103KB)
Export: BibTeX | EndNote (RIS)      

Abstract  

An asymptomatic 71-year-old woman was admitted to the hospital due to aneurysm of visceral artery. CT angiography revealed that she possessed a hepatosplenic artery aneurysm with hepatosplenomesenteric trunk anomaly. The aneurysm was big with diameter about 28 mm, and is very adjacent to the superior mensenteric artery. The neck of the aneurysm is wide (the diameter of the neck was 5.5-6.0 mm) and short (length of the proximal landing zone was about 2.0 mm). The patient received endovascular reconstruction of the hepatosplenic artery and coil embolization of the aneurysm, and got satisfactory result.



Key wordsAneurysm/surgery      Endovascular treatment      Case reports     
Received: 14 August 2018      Published: 15 March 2019
CLC:  R654  
Corresponding Authors: ZHAO Wenjun     E-mail: shenyangaiss@163.com;tzzhaowj@163.com
Cite this article:

SHEN Yang,ZHANG Ruili,CHEN Guang,LI Fei,CHU Haiwei,HU Bin,ZHAO Wenjun. One case of hepatosplenic artery aneurysm with hepato-splenomesenteric trunk and literature review. J Zhejiang Univ (Med Sci), 2018, 47(6): 601-605.

URL:

http://www.zjujournals.com/med/10.3785/j.issn.1008-9292.2018.12.06     OR     http://www.zjujournals.com/med/Y2018/V47/I6/601


血管内治疗肝总-脾-肠系膜上动脉共干合并肝总-脾动脉干动脉瘤一例

一例无症状71岁女性患者因"体检发现内脏动脉瘤7 d"入院。胸腹主动脉CT血管造影提示肝总-脾动脉干真性动脉瘤合并肝总-脾-肠系膜上动脉共干畸形。患者肝总-脾动脉干真性动脉瘤瘤体大(直径约为28 mm)并紧贴肠系膜上动脉起始部,动脉瘤颈宽(直径为5.5~6.0 mm)且短(近端锚定区长度约为2.0 mm)。患者接受了肝总-脾动脉干血管内重建、动脉瘤弹簧圈栓塞、支架隔绝等血管内治疗后恢复良好。


关键词: 动脉瘤/外科学,  血管内治疗,  病例报告 
Fig 1 CT angiography before endovascular treatment
Fig 2 Anatomic features of the hepatosplenic artery aneurysm
Fig 3 Endovascular treatment for hepatosplenic artery aneurysm with hepatosplenomesenteric trunk
Fig 4 CT angiography four months after endovascular treatment
[1]   VENIERATOS D , PANAGOULI E , LOLIS E et al. A morphometric study of the celiac trunk and review of the literature[J]. Clin Anat, 2013, 26 (6): 741- 750
doi: 10.1002/ca.v26.6
[2]   LIPSHUTZ B . Acomposite study of the coeliac axis artery[J]. Ann Surg, 1917, 65 (2): 159- 169
doi: 10.1097/00000658-191702000-00006
[3]   IEZZI R , COTRONEO A R , GIANCRISTOFARO D et al. Multidetector-row CT angiographic imaging of the celiac trunk:anatomy and normal variants[J]. Surg Radiol Anat, 2008, 30 (4): 303- 310
doi: 10.1007/s00276-008-0324-7
[4]   SONG S Y , CHUNG J W , YIN Y H et al. Celiac axis and common hepatic artery variations in 5002 patients:systematic analysis with spiral CT and DSA[J]. Radiology, 2010, 255 (1): 278- 288
doi: 10.1148/radiol.09090389
[5]   HIGASHI N , SHIMADA H , SIMAMURA E et al. Branching patterns of the celiac artery as the hepato-gastro-splenic trunk[J]. Kaibogaku Zasshi, 2009, 84 (1): 7- 10
[6]   PETSCAVAGE J M , MALDJIAN P . Celiomesenteric trunk:two variants of a rare anomaly[J]. Australas Radiol, 2007, 51 Suppl:B306- B309
[7]   WANG Y , CHEN P , SHEN N et al. Celiomesenteric trunk with concurrent aneurysm:report of a case[J]. Surg Today, 2010, 40 (5): 477- 481
doi: 10.1007/s00595-009-4164-9
[8]   WANG C , CAI X , LIANG F et al. Surgical treatment of celiomesenteric trunk aneurysm-7 case report[J]. Biomed Mater Eng, 2014, 24 (6): 3487- 3492
[9]   CONNOLLY P H , MELTZER A J , GALLAGHER K A et al. A visceral aortic branch anomaly presenting with a common celiomesenteric-renal trunk[J]. J Vasc Surg, 2013, 57 (6): 1675
doi: 10.1016/j.jvs.2012.08.097
[10]   MALDJIAN P D , CHORNEY M A . Celiomesenteric and hepatosplenomesenteric trunks:characterization of two rare vascular anomalies with CT[J]. Abdom Imaging, 2015, 40 (6): 1800- 1807
doi: 10.1007/s00261-014-0312-9
[11]   PILLEUL F , BEUF O . Diagnosis of splanchnic artery aneurysms and pseudoaneurysms, with special reference to contrast enhanced 3D magnetic resonance angiography:a review[J]. Acta Radiol, 2004, 45 (7): 702- 708
doi: 10.1080/02841850410001358
[12]   MESSINA L M , SHANLEY C J . Visceral artery aneurysms[J]. Surg Clin North Am, 1997, 77 (2): 425- 442
doi: 10.1016/S0039-6109(05)70559-4
[13]   GREGO F G , LEPIDI S , RAGAZZI R et al. Visceral artery aneurysms:a single center experience[J]. Cardiovasc Surg, 2003, 11 (1): 19- 25
[14]   OBARA H , MATSUMOTO K , FUJIMURA N et al. Reconstructive surgery for a fusiform common celiomesenteric trunk aneurysm and coexistent abdominal aortic aneurysm:report of a case[J]. Surg Today, 2009, 39 (1): 55- 58
doi: 10.1007/s00595-008-3784-9
[15]   TANDLER J . On the varieties of the arteria coeliaca and their developement[J]. Anat Embryol, 1904, 25 (2): 473- 500
[16]   PINKERTON J A , WOOD W G , FOWLER D . Fibrodysplasia with dissecting aneurysm of the hepatic artery[J]. Surgery, 1976, 79 (6): 721- 723
[17]   WELLING T H , WILLIAMS D M , STANLEY J C . Excessive oral amphetamine use as a possible cause of renal and splanchnic arterial aneurysms:a report of two cases[J]. J Vasc Surg, 1998, 28 (4): 727- 731
doi: 10.1016/S0741-5214(98)70103-X
[18]   DAUGHERTY A , POWELLJ T . Recent highlights of ATVB:aneurysms[J]. Arterioscler Thromb Vasc Biol, 2014, 34 (4): 691- 694
doi: 10.1161/ATVBAHA.114.303353
[19]   HIRSCH A T, HASKAL Z J, HERTZER N R, et al. ACC/AHA 2005 Practice Guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease): endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation[J/OL]. Circulation, 2006, 113(11): e463-654.
[20]   HUANG Y K , HSIEH H C , TSAI F C et al. Visceral artery aneurysm:risk factor analysis and therapeutic opinion[J]. Eur J Vasc Endovasc Surg, 2007, 33 (3): 293- 301
doi: 10.1016/j.ejvs.2006.09.016
[21]   MARONE E M , MASCIA D , KAHLBERG A et al. Is open repair still the gold standard in visceral artery aneurysm management?[J]. Ann Vasc Surg, 2011, 25 (7): 936- 946
doi: 10.1016/j.avsg.2011.03.006
[22]   FANKHAUSER G T , STONE W M , NAIDU S G et al. The minimally invasive management of visceral artery aneurysms and pseudoaneurysms[J]. J Vasc Surg, 2011, 53 (4): 966- 970
doi: 10.1016/j.jvs.2010.10.071
[23]   LAGANà D , CARRAFIELLO G , MANGINI M et al. Multimodal approach to endovascular treatment of visceral artery aneurysms and pseudoaneurysms[J]. Eur J Radiol, 2006, 59 (1): 104- 111
doi: 10.1016/j.ejrad.2006.02.004
[24]   TULSYAN N , KASHYAP V S , GREENBERG R K et al. The endovascular management of visceral artery aneurysms and pseudoaneurysms[J]. J Vasc Surg, 2007, 45 (2): 276- 283
doi: 10.1016/j.jvs.2006.10.049
[25]   CARR S C , PEARCE W H , VOGELZANG R L et al. Current management of visceral artery aneurysms[J]. Surgery, 1996, 120 (4): 627- 633
doi: 10.1016/S0039-6060(96)80009-2
[26]   SACHDEV-OST U . Visceral artery aneurysms:review of current management options[J]. Mt Sinai J Med, 2010, 77 (3): 296- 303
doi: 10.1002/msj.v77:3
[27]   GHARIANI M Z , GEORG Y , RAMIREZ C et al. Long-term results of surgical treatment of aneurysms of digestive arteries[J]. Ann Vasc Surg, 2013, 27 (7): 954- 958
doi: 10.1016/j.avsg.2013.02.007
[1] ZHOU Haijin,XIA Ping,HU Xingyue. A case of neuromyelitis optica spectrum disorders complicated with systemic lupus erythematosus and thymoma[J]. J Zhejiang Univ (Med Sci), 2018, 47(1): 71-74.
[2] LI Yao,CHEN Hui. A case of insulinoma complicated with secondary adrenal insufficiency[J]. J Zhejiang Univ (Med Sci), 2017, 46(6): 662-665.
[3] FANG Bing, QIAN Cong, JIANG Dingyao, XU Jing, YU Jun, CHEN Xianyi, XU Liang, CHEN Gao, ZHANG Jianmin. Hypoglossal canal dural arteriovenous fistulas treated with transvenous embolization:report of two cases and literature review[J]. J Zhejiang Univ (Med Sci), 2017, 46(4): 445-448.
[4] WEN Hong, CHEN Lu, YAN Kai, HE Jing. Prenatal diagnosis of Joubert syndrome:one case report and literature review[J]. J Zhejiang Univ (Med Sci), 2017, 46(3): 274-278.
[5] CHEN Yonghua,LIANG Li,FANG Yanlan,WANG Chunlin,LI Linfa,JIANG Tian'an. Iodine 131 joint radio frequency ablation treatment for child with hyperthyroidism goiter: one case report[J]. J Zhejiang Univ (Med Sci), 2017, 46(1): 89-91.
[6] SHEN Zhixin, GAO Enfang, WENG Wenqing, LUO Weiling. Hereditary vitreous degeneration muddy: report of ten cases[J]. J Zhejiang Univ (Med Sci), 2016, 45(6): 636-640.
[7] HE Zhan, DING Fang, RONG Jiandong, GAN Yongli. A case of idiopathic hypertrophic cranial pachymeningitis presenting as chronic subdural hematoma[J]. J Zhejiang Univ (Med Sci), 2016, 45(5): 540-543.
[8] OU Changjiang, WANG Shenghu, CHEN Yili, MO Jun, ZHAO Xuequn. Microvascular decompression for hemifacial spasm induced by vertebral artery dissecting aneurysm: one case report[J]. J Zhejiang Univ (Med Sci), 2016, 45(5): 536-539.
[9] DING Xia, LI Yan, CUI Yiyi, SHEN Yingying, GU Jianzhong, GUO Yong. Fibromyalgia syndrome after comprehensive treatment of breast cancer: a case report[J]. J Zhejiang Univ (Med Sci), 2016, 45(4): 429-431.
[10] MAO Lingna, GUO Qingqu, WANG Guifeng, SONG Zhenya. A case of neurofibromatosis complicated with small bowel obstruction[J]. J Zhejiang Univ (Med Sci), 2016, 45(3): 297-301.
[11] YAN Wei, MOU Chao-hui, WU Sheng, LING Chen-han, WU Qun, HONG Yuan, CHEN Sheng, CAI Feng, ZHANG Jian-min, CHEN Gao. Pterional keyhole approach in surgical treatment of ruptured anterior circulation intracranial aneurysm: a report of 313 cases[J]. J Zhejiang Univ (Med Sci), 2015, 44(4): 366-370.
[12] QIN Bin, YING Guang-yu, HU Hua, CHEN Gao, ZHANG Jian-min, WANG Lin. Surgical treatment of anterior circulation aneurysms via lateral supraorbital approach[J]. J Zhejiang Univ (Med Sci), 2015, 44(4): 383-388.
[13] CHEN Xian-yi, WANG Lin, FANG Bing, YU Jun. A3-A3 side-to-side anastomosis combined with endovascular intervention in recurrent complex anterior artery aneurysm: a case report and literature review[J]. J Zhejiang Univ (Med Sci), 2015, 44(4): 396-399.
[14] LU Pei-ying, GU Wei, PANG Xiao-hong, SHAN Peng-fei. A rare case of Silver-Russell syndrome in adult and literature review[J]. J Zhejiang Univ (Med Sci), 2015, 44(3): 335-338.
[15] FANG Xing, XU Zi-qi, LUO Ben-yan, YUAN Huai-wu, ZHU Xiong-chao, YUAN Yuan. Carotid artery dissection with Horner syndrome as main manifestation:a case report[J]. J Zhejiang Univ (Med Sci), 2015, 44(2): 229-232.