Compressive pancreaticoduodenal artery aneurysm associated with celiac artery stenosis

Peripancreatic artery aneurysms are a rare condition, representing <2% of all splanchnic artery aneurysms, and have been significantly related to celiac axis stenosis. While they are most often asymptomatic, those aneurysms have a strong tendency to rupture (52% rupture rate at the initial presentation) and, in this case, the outcome is often dramatic. Given that reports of this disease are rare, appropriate guidelines are difficult to formulate and different treatment strategies have been proposed. Endovascular management seems to be efficient in the large majority of most recent reports, but open surgery still remains necessary for complex cases, especially when associated with celiac axis stenosis. We report a new occurrence of a symptomatic compressive aneurysm related to common bile duct compression that we treated using a hybrid procedure.