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Journal of Surgical Case Reports 2017-Feb

Acute pancreatitis caused by pancreatic ischemia after TEVAR combined with intentional celiac artery coverage and embolization of the branches of the celiac artery.

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Yohei Kawatani
Hirotsugu Kurobe
Yoshitsugu Nakamura
Yuji Suda
Yoshinori Okuma
Shinichiro Sato
Toru Hashimoto
Takaki Hori

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Abstrè

Covering and embolizing the celiac artery has been reported to be a relatively safe procedure, owing to the rich collateral pathway between the celiac artery and superior mesenteric artery. A 69-year-old man presented with an aneurysm on the distal descending aorta. The proximity of the aneurysm to the celiac artery origin necessitated covering the artery with a stent graft. Additionally, the celiac trunk was short, increasing the risk for Type II endoleak. The origin of the celiac artery was covered after embolization of the branches of the celiac artery. Postoperatively, nausea and abdominal pain appeared, and the amylase level and white blood cell count were elevated. Contrast-enhanced computed tomography and abdominal ultrasonography revealed necrosis and cyst formation in the pancreatic tail, resulting in a diagnosis of acute pancreatitis caused by pancreatic ischemia. Conservative treatment was applied. After discharge, although walled-off necrosis remained, the patient was doing well, without any clinical symptoms.

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