Treatment of an aneurysm of the celiac artery arising from a celiomesenteric trunk. Report of a case

INTRODUCTION: Visceral artery aneurysms (VAA) are rare, frequently present as a life-threatening emergency and are often fatal. The celiacomesenteric trunk (CMT), a common origin of the celiac trunk (CT) and the superior mesenteric artery (SMA) from abdominal aorta, is quite rare. Aneurysms that involve this celiomesenteric anomaly are even rarer and in the last 32 years have been reported in only 20 cases in the literature. PRESENTATION OF CASE: We describe a case with 30 mm aneurysm arising from a CMT. In general, an aneurysm that is 20 mm or greater in size is considered to be significant enough to warrant treatment. Abdominal VAA sometimes can be treated with low-invasive procedures: our patient required open surgical repair with the celiac artery replanted on to the aorta. DISCUSSION: The clinical course was complicated only by an increase of hepatic cytolysis enzymes, and by a low output pancreatic fistula, treated conservatively. The patient was discharged on the fifteenth postoperative day. One month after discharge, imaging revealed a good patency of all reconstructed arteries. In the subsequent 36-month follow-up period, the patient reported no clinical episodes. CONCLUSION: Our finding of a very rare case of a celiomesenteric anomaly with a concurrent aneurysm is extremely rare (20 cases in word literature in the last 32 years). The feasibility of the endovascular approach for aneurysms originating from the common celiomesenteric trunk depends mainly on aneurysmal location, diameter and neck size. In case of specific unfit anatomy, a careful surgical treatment can ensure the best results.