Co esponding au ho : HAJAR DAHMAN
Copy igh © 2025 Au ho (s) e ain he copy igh o his a icle. This a icle is published unde he e ms o he C ea i e Commons A ibu ion Liscense 4.0.
Inciden al saccula aneu ysm o he celiac unk: A a e cause o abdominal pain
HAJAR DAHMAN *, IHSANE MANSIR, YOUSSEF BOUKTIB, AYOUB ELHAJJAMI, BADR BOUTAKIOUTE,
MARIEM OUALI IDRISSI and NAJAT IDRISSI EL GANOUNI
Depa men o Radiology, ARRAZI Hospi al, Mohammed VI Uni e si y hospi al, FMPM, Ma akech, Mo occo.
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 26(02), 1742-1745
Publica ion his o y: Recei ed on 03 Ap il 2025; e ised on 11 May 2025; accep ed on 13 May 2025
A icle DOI: h ps://doi.o g/10.30574/wja .2025.26.2.1774
Abs ac
Celiac a e y aneu ysms (CAAs) a e a e ascula anomalies, o en disco e ed inciden ally o du ing he e alua ion o
non-speci ic abdominal symp oms. Despi e hei a i y, hey a e clinically signi ican due o he isk o up u e, which
can be li e- h ea ening. We epo he case o a 58-yea -old woman who p esen ed wi h p og essi e abdominal pain.
Con as -enhanced compu ed omog aphy (CT) o he abdomen e ealed a well-de ined saccula aneu ysm in ol ing
he celiac unk. The aneu ysm demons a ed con as opaci ica ion and was clea ly delinea ed om adjacen
s uc u es. No signs o up u e o su ounding in lamma ion we e iden i ied. This case illus a es he key ole o c oss-
sec ional imaging—pa icula ly CT angiog aphy—in he de ec ion, cha ac e iza ion, and assessmen o isce al a e y
aneu ysms. I also ein o ces he need o adiologis s and clinicians o include ascula e iologies in he di e en ial
diagnosis o abdominal pain, especially in pa ien s wi hou clea gas oin es inal o gynecologic causes.
Keywo ds: Celiac unk aneu ysm; Visce al a e y aneu ysm; Abdominal pain; Compu ed omog aphy; Endo ascula
ea men
1. In oduc ion
Visce al a e y aneu ysms (VAAs) a e uncommon, wi h an es ima ed incidence o 0.01–0.2% in he gene al popula ion
[1]. Among hem, celiac a e y aneu ysms (CAAs) ep esen a small subse , accoun ing o app oxima ely 4–30% o
VAAs [2,3]. Al hough o en asymp oma ic and inciden ally disco e ed, CAAs a e clinically ele an due o hei isk o
up u e, pa icula ly in lesions exceeding 2 cm [4]. The inc easing a ailabili y o high- esolu ion c oss-sec ional imaging
has con ibu ed o a ise in inciden al de ec ion. Howe e , gi en hei a i y, he na u al his o y and op imal
managemen s a egies emain poo ly de ined. We epo he case o a pa ially h ombosed, calci ied saccula
aneu ysm o he celiac unk inciden ally disco e ed in a symp oma ic pa ien , and we e iew he ele an li e a u e.
2. Case P esen a ion
A 58-yea -old woman wi h no signi ican pas medical his o y p esen ed o he eme gency depa men wi h ague
epigas ic and le uppe quad an abdominal pain pe sis ing o se e al days. She denied any his o y o auma,
gas oin es inal bleeding, o weigh loss. Physical examina ion was un ema kable, and i al signs we e s able.
Labo a o y in es iga ions, including comple e blood coun , li e unc ion es s, and in lamma o y ma ke s, we e wi hin
no mal limi s.
An abdominopel ic con as -enhanced compu ed omog aphy (CT) scan was pe o med o e alua e he cause o he
symp oms. Imaging e ealed a well-de ined saccula aneu ysm a ising om he o igin o he celiac unk. The
aneu ysmal sac was pa ially opaci ied by con as , wi h e idence o mu al h ombus and pe iphe al wall calci ica ions.
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 26(02), 1742-1745
1743
No signs o up u e, pe i ascula hema oma, o su ounding in lamma o y changes we e no ed. The hepa ic, splenic,
and le gas ic a e ies o igina ed no mally om he celiac unk and showed no signs o dissec ion o dis al s enosis.
No addi ional ascula anomalies o abdominal o gan abno mali ies we e iden i ied. These indings led o he diagnosis
o an isola ed saccula aneu ysm o he celiac unk.
Gi en he aneu ysm's size and mo phology, a ascula su ge y consul a ion was ob ained.
Figu e 1 Axial abdominal CT images illus a ing a saccula aneu ysm o he celiac unk.
(A) Non-con as axial image showing pe iphe al wall calci ica ions o he aneu ysmal sac.
(B, C) A e ial-phase con as -enhanced axial images demons a ing pa ial opaci ica ion o he aneu ysm, wi h
isualiza ion o a ma ginal mu al h ombus
Figu e 2 Sagi al con as -enhanced CT images (B : MIP econs uc ion) showing a saccula aneu ysm o he celiac
unk. The aneu ysm exhibi s pe iphe al wall calci ica ions. The MIP econs uc ion (B) enhances he isualiza ion o
he aneu ysmal mo phology and i s ela ionship o he caeliac unk (a ow)
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 26(02), 1742-1745
1744
3. Discussion
Celiac a e y aneu ysms a e a e bu po en ially a al lesions, wi h up u e a es eaching up o 40% in some epo s
[2,5]. They a e mo e equen ly diagnosed oday due o he ou ine use o CT and MR angiog aphy. Mos CAAs emain
asymp oma ic and a e ound inciden ally du ing imaging pe o med o un ela ed complain s [6].
When symp oms do occu , hey a e usually ague and nonspeci ic, such as uppe abdominal pain, nausea, o
pos p andial discom o [7]. In ou case, he pa ien p esen ed wi h mild pe sis en pain, p omp ing imaging and
e en ual diagnosis. The imaging ea u es—including saccula mo phology, mu al h ombus, and wall calci ica ions—
a e ypical o degene a i e aneu ysms, mos commonly a ibu ed o a he oscle osis [3,8]. O he causes include auma,
asculi is, ib omuscula dysplasia, and gene ic connec i e issue diso de s like Ma an o Ehle s-Danlos synd omes [9].
The isk o up u e co ela es wi h he size and mo phology o he aneu ysm. Al hough ea ly su gical li e a u e
sugges ed ea men a a h eshold o 2 cm, cu en ecommenda ions a o a mo e indi idualized app oach, balancing
he aneu ysm’s cha ac e is ics wi h pa ien -speci ic ac o s [4,10]. Symp oma ic aneu ysms, o hose exceeding 25 mm
in diame e , gene ally wa an close ollow-up o in e en ion [1].
C oss-sec ional imaging plays an essen ial ole no only in diagnosis bu also in moni o ing he aneu ysm's e olu ion
and de ec ing complica ions such as expansion, h ombosis, o leak [11].
While ea men op ions such as open su gical epai o endo ascula managemen (e.g., coiling, s en -g a s) a e
a ailable and ha e shown a o able ou comes in selec ed cases [12], no all aneu ysms equi e immedia e in e en ion.
The decision mus be guided by mul idisciplina y e alua ion, a ailabili y o expe ise, and pa ien p e e ence
4. Conclusion
This case illus a es he impo ance o including ascula causes—such as celiac unk aneu ysms—in he di e en ial
diagnosis o abdominal pain. Though a e, CAAs can pose signi ican clinical isks i no ecognized ea ly. C oss-sec ional
imaging is undamen al o diagnosis, cha ac e iza ion, and ollow-up. In asymp oma ic o s able cases, conse a i e
managemen wi h egula imaging may be app op ia e, while selec ed cases may bene i om endo ascula o su gical
in e en ion depending on he clinical con ex .
Compliance wi h e hical s anda ds
Disclosu e o con lic o in e es
No con lic o in e es o be disclosed.
S a emen o in o med consen
In o med consen was ob ained om all indi idual pa icipan s included in he s udy.
Re e ences
[1] Chae RA, Abula age CJ, Coleman DM, e al. The Socie y o Vascula Su ge y clinical p ac ice guidelines on he
managemen o isce al aneu ysms. J Vasc Su g. 2020;72(1S):3S–39S.
[2] Pulli R, Innocen i AA, Ba ban i E, e al. Visce al a e y aneu ysms: one cen e ’s expe ience. J Vasc Su g.
2008;48(2):334–342.
[3] Pi on MB, Dappa E, Jungmann F, e al. Visce al a e y aneu ysms: incidence, managemen , and ou come analysis.
Eu Radiol. 2015;25(7):2004–2014.
[4] Tulsyan N, Kashyap VS, G eenbe g RK, e al. Endo ascula managemen o isce al a e y aneu ysms and
pseudoaneu ysms. J Vasc Su g. 2007;45(2):276–283.
[5] Ca SC, Mah i DM, Hoch JR, e al. Visce al a e y aneu ysm up u e. J Vasc Su g. 2001;33(4):806–811.
[6] Shanley CJ, Shah NL, Messina LM. Common splanchnic a e y aneu ysms: splenic, hepa ic, and celiac. Ann Vasc
Su g. 1996;10(3):315–322.
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 26(02), 1742-1745
1745
[7] Ba ionue o P, Malas MB, Nejim B, e al. A sys ema ic e iew and me a-analysis o he managemen o isce al
a e y aneu ysms. J Vasc Su g. 2020;72(1S):40S–45S.
[8] Vaidya S, Mahmood SN, Collins J. Aneu ysms o he isce al a e ies. Semin In e en Radiol. 2009;26(3):196–
206.
[9] E ben Y, De Ma ino RR, Bja nason H, e al. Ope a i e managemen o celiac a e y aneu ysms. J Vasc Su g.
2015;62(3):610–615.
[10] Ma inelli O, I ace L, Ven u ini M, e al. Technical conside a ions in endo ascula managemen o ue isce al
a e y aneu ysms. CVIR Endo asc. 2023;6(1):1–9.
[11] Wang L, Wu Z, Wang Y, e al. Imaging ea u es and diagnosis o celiac a e y aneu ysms: a case se ies and
li e a u e e iew. Radiol Med. 2022;127(9):976–984.
[12] Rossi M, K okidis M, Kashe E, e al. CIRSE S anda ds o P ac ice o he Endo ascula T ea men o Visce al and
Renal A e y Aneu ysms. Ca dio asc In e en Radiol. 2024;47(1):26–35.
