A CASE OF DUODENAL OBSTRUCTION AT THE THIRD PORTION INDUCED BY INFLAMMATION WHICH CAUSED BY TWO COLLATERAL ARTERIES AND TWO ANEURYSMS WITH CELIAC OBUSTRUCTION RESULTING IN DISAPPEARANCE OF THE ANEURYSMS IN A CLINICAL COURSE

We experianced a patient with inflammation around the duodenum accompanied by 2 collateral arteries and 2 aneurysms, which caused duodenal obstruction at the third portion. The formers were of pancreaticoduodenal and of dorsal pancreatic artery, and the latters were of the inferior pancreaticol duodenal artry and of the branch of superior mesentric artery. It was thought that these collateral arteries had been induced by complete occlusion of the celiac axis, and these aneurysms, were induced by circulatory disturbance around the radix of superior mesentric artery. In an angiography taken about one year after the operation these aneurysms disappeared and the collateral arteries enlarged enough to be supplied from the superior mesentric artery. These findings suggest that such aneurysms, as mentioned above, disappear with improvement of circuratory condition. So we believe that it is certainly reasonable to consider circulatory disturbance as a part of etiology in aneurysm.