Inferior Pancreaticoduodenal Artery Aneurysms: Diagnostic Challenges and Management Outcomes-A Systematic Review of 113 Cases.
Rotem Horowitz, Shai Hoffman, Moshe Argaman et al.
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In 30 seconds
This systematic review analyzed 113 adult patients with inferior pancreaticoduodenal artery aneurysms reported in 81 publications to describe presentation, diagnostic challenges, treatment, and outcomes. Rupture was reported in 70.2% of cases, and overall mortality was 9.6% (10/104). Abdominal pain was the most common presentation (71.7%), while diagnostic pitfalls were documented in 47.4%. Endovascular treatment had numerically lower mortality than open surgery, but the difference was not statistically significant. The authors note that the available data cannot establish whether earlier recognition reduces mortality.
Key findings
- Rupture occurred in 70.2% of cases; overall mortality was 9.6% (10/104).
- Abdominal pain was reported in 71.7% of patients, and diagnostic pitfalls in 47.4%.
- Celiac axis stenosis was identified in 71.7% of patients.
- Mortality was 3.5% with endovascular treatment versus 14.3% with open surgery; the difference was non-significant (P = 0.08).
Why it matters
The high proportion of ruptured aneurysms and frequent diagnostic pitfalls underscore the clinical challenge of recognizing this uncommon cause of abdominal pain. The review also highlights the frequent coexistence of celiac axis stenosis. These findings can inform diagnostic awareness, while the case-based evidence does not establish that earlier recognition improves survival or that one treatment approach is superior.
What to keep in mind
The review is based on case reports and series, and the authors state that whether earlier recognition reduces mortality cannot be determined from the available data.