Inferior pancreaticoduodenal artery aneurysms and Dunbar syndrome. Experience with the open surgery

Introduction: Median arcuate ligament or Dunbar syndrome is a rare vascular disorder causing celiac trunk stenosis or occlusion due to the extrinsic compression by the median arcuate ligament. A visceral aneurysm may develop as a complication. Patients and methods: We experienced an inferior pancreaticoduodenal artery aneurysm presentation in two female patients with the median arcuate syndrome previously diagnosed. One patient presented with postprandial abdominal pain and weight loss and the other one was asymptomatic. Results: We described our experience with the both patients being successfully treated surgically. Conclusions: Awareness of possible repercussions of the celiac trunk stenosis to peripancreatic arteries should be elevated. Restoration of physiological blood flow by removing pathologic anatomy should be performed. Since there is no correlation between the size of a visceral aneurysm and the risk of rupture, having a high postrupture mortality, pancreaticoduodenal artery aneurysms should be treated even if asymptomatic. Surgical treatment remains the mainstay treatment of the Dunbar syndrome complicated by visceral aneurysms.