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One visceral artery may be enough; successful pancreatectomy in a patient with total occlusion of the celiac and superior mesenteric arteries

Overview of attention for article published in BMC Surgery, May 2018
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Title
One visceral artery may be enough; successful pancreatectomy in a patient with total occlusion of the celiac and superior mesenteric arteries
Published in
BMC Surgery, May 2018
DOI 10.1186/s12893-018-0352-0
Pubmed ID
Authors

Evangelos Tagkalos, Florian Jungmann, Hauke Lang, Stefan Heinrich

Abstract

The anatomic variations of the visceral arteries are not uncommon. The liver arterial blood supply shows 50% variability between humans, with the most common anatomy being one hepatic artery arising from the celiac trunk and one pancreatico-duodenal arcade between the celiac trunk and the superior mesenteric artery. Occlusion of one artery are mostly asymptomatic but may become clinically relevant when surgery of the liver, bile duct or the pancreas is required. If these pathologies are not reversible, an oncologic pancreatic head resection cannot be performed. We report the case of a 64-year-old Caucasian female patient with a locally advanced, resectable adenocarcinoma of the pancreas with complete atherosclerotic occlusion of the celiac trunk and the superior mesenteric artery. This vascular anomaly was missed on the preoperative imaging and became known postoperatively. A collateral circulation from a hypertrophic inferior mesenteric artery to the celiac trunk and the superior mesenteric artery compensated the blood supply to the visceral organs. The postoperative course was complicated by an elevation of the transaminases AST/ALT, which normalized under conservative treatment with alprostadil (prostavasin™) and anticoagulation, since angiographic recanalization failed. The patient recovered fully and was discharged at the 14th postoperative day. Two years later, she required endovascular repair of an aortic rupture during which the inferior mesenteric artery was preserved. This case underlines the natural potential of the human body to adapt to chronic arterial malperfusion by creating a collateral circulation and supports the need for adequate preoperative imaging, including a proper arterial phase before upper abdominal surgery.

Twitter Demographics

The data shown below were collected from the profiles of 2 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 13 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 13 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 3 23%
Student > Ph. D. Student 2 15%
Other 2 15%
Student > Master 2 15%
Student > Doctoral Student 1 8%
Other 0 0%
Unknown 3 23%
Readers by discipline Count As %
Medicine and Dentistry 6 46%
Social Sciences 1 8%
Nursing and Health Professions 1 8%
Unknown 5 38%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 22 May 2018.
All research outputs
#9,933,618
of 12,980,529 outputs
Outputs from BMC Surgery
#214
of 496 outputs
Outputs of similar age
#188,123
of 269,337 outputs
Outputs of similar age from BMC Surgery
#1
of 1 outputs
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So far Altmetric has tracked 496 research outputs from this source. They receive a mean Attention Score of 2.3. This one is in the 41st percentile – i.e., 41% of its peers scored the same or lower than it.
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