What Is a Stomach Aneurysm?
Celiac stem aneurysm (CAA) refers to an aneurysm that occurs in the celiac stem, mostly cystic aneurysms, often accompanied by other multivessel aneurysms. Incidence is rare, accounting for about 4% of all visceral aneurysms, but mortality is extremely high after rupture. Most cases occur in middle age and there is no difference in male to female ratio.
Basic Information
- Visiting department
- Oncology
- Common causes
- Arteriosclerosis or iatrogenic injury.
- Common symptoms
- Most are asymptomatic, and a few have upper abdominal discomfort.
- Contagious
- no
Causes of celiac aneurysms
- (1) Arteriosclerosis due to intimal lipid deposition and nutritional disorders, causing intimal damage, medial membrane degeneration, and weak elastic fiber layers.
(2) Iatrogenic injury, such as hepatic artery intubation chemotherapy, can cause celiac arterial injury.
(3) Others such as infection and trauma are also the cause of the disease and are rare.
Clinical manifestations of celiac stem aneurysms
- Most are asymptomatic. Some patients show epigastric discomfort; some patients may have significant abdominal pain, radiation to the back, and vomiting, and may be mistaken for pancreatitis or peptic ulcer. Intestinal colic rarely occurs. Once it occurs, it should be considered due to the combination of mesenteric lesions. Abdomen and murmur were audible and absent in the abdomen of patients, but no specificity was detected in about 1/3 of the patients. Abdominal pain, pulsatile mass, gastrointestinal bleeding, shock, and occasionally obstructive jaundice are often manifested by the rupture of a celiac stem aneurysm, which often ruptures into the abdominal cavity, and rarely ruptures to the gastrointestinal tract. The rupture rate is about 13%.
Celiac stem aneurysm
- 1. Color Doppler ultrasound has a certain prompting effect on the diagnosis, and can understand the arterial diameter and blood flow.
2.CTA examination: Through the reconstruction of the three-dimensional image of the celiac artery, understand the location, size and involvement of the branches of the aneurysm, and understand the relationship with the adjacent organs.
3. Arteriography and DSA: It can clearly show the aneurysm morphology and the blood flow of each branch artery, especially the collateral circulation of the superior mesenteric artery, hepatic artery, spleen artery, and gastroduodenal artery, which is convenient for formulating surgical plans .
Celiac stem aneurysm diagnosis
- Because abdominal aneurysms are usually asymptomatic before rupture, preoperative diagnosis is more difficult, and most of them are found by routine examination. For patients with upper abdominal pain, especially with clinical manifestations of back radiation pain, nausea, and vomiting, routine imaging studies are required. In addition, because celiac stem aneurysms are often accompanied by other arteriosclerotic occlusive diseases or aneurysms, if you find other aortic, peripheral or visceral aneurysms, you should be alert to the possibility of celiac stem aneurysms.
This disease is mainly confirmed by imaging examination. Selective abdominal angiography is the gold standard for diagnosis. Color ultrasound, CTA, and MRA are also of great help in diagnosis.
Celiac Stem Aneurysm Treatment
- Once a celiac aneurysm is diagnosed, early treatment is needed. Treatment methods include surgical treatment and interventional treatment. Surgical treatment methods include tumor resection, autologous vein or artificial blood vessel reconstruction; interventional treatment includes endovascular stent technology and arterial embolization.
The surgical method depends on the tumor size, location, local anatomy, and collateral circulation. The celiac trunk and its important branches (common hepatic artery, splenic artery, left gastric artery, etc.) should be reconstructed as much as possible, but it depends on the specific situation. Abdominal aneurysms are removed and monitoring after anastomosis is very important because abdominal aneurysms are often accompanied by other obstructive diseases or aneurysms.