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Aorto-Hepatic By-Pass Grafting as Treatment Option After Acute Thrombosis of a Celiac Trunk Stenting. Report of a Case

Mohamed Ben Hammamia, Jalel Ziadi, Sobhi Mlaihi, Zied Daoud, Faker Ghedira, Malek Ben Mrad, and Raouf Denguir

Celiac trunk thrombosis is a rare event after percutaneous stenting. Treatment options include surgery or endovascular approach. We report the case of a diabetic female patient of 56 years old with a recurrent chronic mesenteric ischemia related to celiac trunk stenosis. We choose endovascular approach and we performed a stenting of this lesion with a ballon expendable stent of 6 × 29 mm. Acute abdomen occurred at the first postoperative day. Acute mesenteric ischemia was suspected. CT scan objectified a stent thrombosis and beginning of intestinal distress. Because of doubt of intestinal viability, we performed urgently a laparotomy and an anterograde aorto-hepatic bypass. Post-operative course was satisfactory. We put the patient on platelet antiaggregant therapy. One year after, CT scan confirms graft patency. Acute thrombosis of a celiac trunk stenting is an emergency and diagnosis must be performed before the development of end-organ damage. Aorto hepatic bypass can be a good alternative.