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Celiac axis compression syndrome and pancreatic head cancer
Pancreatology 14 (2014) 310e311
Contents lists available at ScienceDirect
Pancreatology journal homepage: www.elsevier.com/locate/pan
IMAGES IN PANCREATOLOGY Celiac axis compression syndrome and pancreatic head cancer Feng Yang a, b, c, Chen Jin a, b, c, Deliang Fu a, b, c, * a
Department of Pancreatic Surgery, Huashan Hospital, Shanghai, China Department of Surgery, Shanghai Medical College, Fudan University, Shanghai, China c Pancreatic Disease Institute, Fudan University, Shanghai, China b
This image from an arterial phase CT scan with three-dimensional reconstruction is from a 65-year-old female patient who has received endoscopic biliary drainage for obstructive jaundice due to locally advanced pancreatic head cancer. It clearly demonstrates stenosis of 80% in the origin of the celiac trunk (solid arrow) (Fig. 1). This finding is significant because celiac axis stenosis is known to be a potentially lifethreatening condition in patients undergoing pancreaticoduodenectomy, although most of the patients are asymptomatic. In the presence of celiac axis stenosis, arterial blood supply to the upper abdominal organs such as the pancreas, liver, stomach, and spleen is sustained via a well-developed system of pancreaticoduodenal collateral pathways in most patients. The present three-dimensional volume-rendered CT
Fig. 1. Celiac axis stenosis identified by three-dimensional CT angiography.
* Corresponding author. Department of Pancreatic Surgery, Huashan Hospital, Shanghai, China. E-mail address: [email protected] (D. Fu). 1424-3903/$ e see front matter http://dx.doi.org/10.1016/j.pan.2014.05.795
F. Yang et al. / Pancreatology 14 (2014) 310e311
311
angiography image also shows a large arcade from the inferior pancreatoduodenal artery to the gastroduodenal artery (open arrow) and an enlarged dorsal pancreatic artery (arrowhead), which formed as a result of stenosis of the celiac axis. Knowledge concerning the collateral pathways is important for regional interventional procedures and pancreaticoduodenectomy [1]. Financial disclosures: This work is supported by the New Outstanding Youth Program of Shanghai Municipal Health Bureau (XYQ2013090) and the Zhuo-Xue Project of Fudan University.
Reference [1] Sakorafas GH, Sarr MG, Peros G. Celiac artery stenosis: an underappreciated and unpleasant surprise in patients undergoing pancreaticoduodenectomy. J Am Coll Surg 2008;206(2):349e56.
Contents lists available at ScienceDirect
Pancreatology journal homepage: www.elsevier.com/locate/pan
IMAGES IN PANCREATOLOGY Celiac axis compression syndrome and pancreatic head cancer Feng Yang a, b, c, Chen Jin a, b, c, Deliang Fu a, b, c, * a
Department of Pancreatic Surgery, Huashan Hospital, Shanghai, China Department of Surgery, Shanghai Medical College, Fudan University, Shanghai, China c Pancreatic Disease Institute, Fudan University, Shanghai, China b
This image from an arterial phase CT scan with three-dimensional reconstruction is from a 65-year-old female patient who has received endoscopic biliary drainage for obstructive jaundice due to locally advanced pancreatic head cancer. It clearly demonstrates stenosis of 80% in the origin of the celiac trunk (solid arrow) (Fig. 1). This finding is significant because celiac axis stenosis is known to be a potentially lifethreatening condition in patients undergoing pancreaticoduodenectomy, although most of the patients are asymptomatic. In the presence of celiac axis stenosis, arterial blood supply to the upper abdominal organs such as the pancreas, liver, stomach, and spleen is sustained via a well-developed system of pancreaticoduodenal collateral pathways in most patients. The present three-dimensional volume-rendered CT
Fig. 1. Celiac axis stenosis identified by three-dimensional CT angiography.
* Corresponding author. Department of Pancreatic Surgery, Huashan Hospital, Shanghai, China. E-mail address: [email protected] (D. Fu). 1424-3903/$ e see front matter http://dx.doi.org/10.1016/j.pan.2014.05.795
F. Yang et al. / Pancreatology 14 (2014) 310e311
311
angiography image also shows a large arcade from the inferior pancreatoduodenal artery to the gastroduodenal artery (open arrow) and an enlarged dorsal pancreatic artery (arrowhead), which formed as a result of stenosis of the celiac axis. Knowledge concerning the collateral pathways is important for regional interventional procedures and pancreaticoduodenectomy [1]. Financial disclosures: This work is supported by the New Outstanding Youth Program of Shanghai Municipal Health Bureau (XYQ2013090) and the Zhuo-Xue Project of Fudan University.
Reference [1] Sakorafas GH, Sarr MG, Peros G. Celiac artery stenosis: an underappreciated and unpleasant surprise in patients undergoing pancreaticoduodenectomy. J Am Coll Surg 2008;206(2):349e56.