Palmucci S, Mauro LA, Milone P, Di Stefano F, Scolaro A, Di Cataldo A, Ettorre GC. Diagnosis of ruptured superior mesenteric artery aneurysm mimicking a pancreatic mass. World J Gastroenterol 2010; 16(18): 2298-2301 [PMID: 20458769 DOI: 10.3748/wjg.v16.i18.2298]
Corresponding Author of This Article
Stefano Palmucci, MD, Department DOGIRA, Section of Radiological Sciences, “Policlinico - Vittorio Emanuele” University Hospital, Via Santa Sofia 78, 95123 Catania, Italy. spalmucci@sirm.org
Article-Type of This Article
Case Report
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World J Gastroenterol. May 14, 2010; 16(18): 2298-2301 Published online May 14, 2010. doi: 10.3748/wjg.v16.i18.2298
Diagnosis of ruptured superior mesenteric artery aneurysm mimicking a pancreatic mass
Stefano Palmucci, Letizia Antonella Mauro, Pietro Milone, Francesco Di Stefano, Antonino Scolaro, Antonio Di Cataldo, Giovanni Carlo Ettorre
Stefano Palmucci, Letizia Antonella Mauro, Pietro Milone, Giovanni Carlo Ettorre, Department DOGIRA, Section of Radiological Sciences, “Policlinico - Vittorio Emanuele” University Hospital, Via Santa Sofia 78, 95123 Catania, Italy
Francesco Di Stefano, Antonino Scolaro, Division of Phlebologic Vascular Surgery, Hospital “Garibaldi Nesima”, Via Palermo 636, 95122 Catania, Italy
Antonio Di Cataldo, Department of General and Colorectal Surgery, “Policlinico - Vittorio Emanuele” University Hospital, 95123 Catania, Italy
Author contributions: Palmucci S and Di Cataldo A designed and performed research on visceral aneurysm and peripancreatic masses; Palmucci S, Mauro LA, Milone P and Ettorre GC performed multidetector computed tomography and magnetic resonance imaging; Di Stefano F and Scolaro A treated the patient; Palmucci S and Mauro LA wrote the paper.
Correspondence to: Stefano Palmucci, MD, Department DOGIRA, Section of Radiological Sciences, “Policlinico - Vittorio Emanuele” University Hospital, Via Santa Sofia 78, 95123 Catania, Italy. spalmucci@sirm.org
Telephone: +39-95-3782360 Fax: +39-95-3782360
Received: January 15, 2010 Revised: February 18, 2010 Accepted: February 25, 2010 Published online: May 14, 2010
Abstract
Aneurysms and pseudoaneurysms of the superior mesenteric artery are potentially lethal and should be treated as urgently as possible. In a 52-year-old man with occasional epigastric pain, we accidentally discovered a superior mesenteric artery aneurysm that was ruptured with spontaneous tamponade in the uncinate process and in the head of the pancreas. The ruptured aneurysm had a heterogeneous appearance due to its thrombotic and hemorrhagic content, and it simulated a voluminous mass in the head and uncinate process of the pancreas, associated with mild dilatation of the main pancreatic duct. Recent advances in multidetector computed tomography and magnetic resonance imaging have enabled radiologists to develop a correct diagnosis of mesenteric aneurysms and pseudoaneurysms of the visceral branches of the abdominal aorta, and to differentiate this diagnosis from that of pancreatic or peripancreatic masses; angiography is currently used to confirm a diagnosis and to develop therapeutic treatments.
