Celiac artery aneurysm: report of two surgical cases

Celiac artery aneurysms are uncommon and only 21 cases have been reported in Japan. We present herein two cases of celiac artery aneurysm treated by aneurysmectomy and vascular reconstruction, and review the Japanese literature documented between 1969 and 1997. Our two patients were asymptomatic, and their aneurysms were detected incidentally by abdominal computed tomography (CT) and ultrasonography during investigations of other disorders. The celiac trunk was imaged well by three-dimensional CT angiography, which proved very effective for determining the best surgical approach and type of operation. Aneurysmectomy and reconstruction of the common hepatic and splenic arteries with direct end-to-end anastomosis was performed successfully in both patients. Pathological examination revealed medial degeneration with loss of elastic fibers and atherosclerotic changes that were probably secondary. In Japan, 13 patients (61.9%) have been surgically treated and several methods of vascular reconstruction with grafting have been reported; however, there have been no previous reports of an end-to-end anastomosis without grafting as described herein.