Pancreaticoduodenal Artery Aneurysms

Pancreaticoduodenal artery aneurysms are rare but challenging surgical problems. While physical examination, ultrasound, and computed tomography scans may suggest the diagnosis, more definitive information may be achieved noninvasively by scintiangiog raphy. Angiography is the diagnostic gold standard and remains crucial for rational planning of operative strategy. Surgical repair is usually achieved by exclusion or endoa neurysmorrhaphy. Through use of modern diagnostic and surgical approaches, mortality rates have been reduced from as high as 22% to 6%. The authors herein describe 2 patients with pancreaticoduodenal artery aneurysms and review the management strate gies of this challenging problem.