Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Superior Mesenteric Artery originating from the celiac axis: A rare vascular anomaly | Wayne et al. World Journal of Surgical Oncology 2011 9 71 http content 9 1 71 7 WORLD JOURNAL OF SURGICAL ONCOLOGY CASE REPORT Open Access Superior Mesenteric Artery Originating from the Celiac Axis A Rare Vascular anomaly Michael G Wayne Rahul Narang Suzanne Verzosa and Avram Cooperman Abstract The knowledge of the vascular anatomy of the concerned region is an important prerequisite for planning surgical intervention. The awareness of the existing vascular anomalies enhances the insight regarding that region. We report a patient undergoing preoperative evaluation with CTA finding of Superior Mesenteric Artery SMA originating from the celiac artery. This celiac-mesenteric trunk is rare 1 . Case Presentation A 74-year-old woman was referred by her gastroenterologist with painless jaundice. She presented with several months of decreased appetite and a three week history of light colored stool with dark urine. An endoscopic ultrasound was performed and revealed a hypoechoic irregular cm mass in the head of the pancreas. The common bile duct and pancreatic duct were obstructed from the mass. No vascular invasion celiac or periceliac lymph nodes were noted. Two biliary stents were placed and no biopsies were taken during the procedure. Prior to considering the patient a candidate for surgery a high resolution computed tomography CT scan was performed with pancreatic protocol in non-contrast arterial and venous phase to determine resectablity. CT scan was consistent with a double duct sign with markedly dilated pancreatic and common bile duct and intra-hepatic biliary dilation secondary to mass on the pancreatic head. An interesting variant in anatomy was also identified which was important for proper surgical planning. The superior mesenteric artery was found to be originating from the celiac axis. Figure 1 2 3 Pancreaticoduodenectomy is utilized selectively in the management of patients with neoplastic lesions of the pancreas and periampullary region.
