{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T05:38:43Z","timestamp":1792820323257,"version":"4.5.0"},"reference-count":79,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:00:00Z","timestamp":1780358400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:00:00Z","timestamp":1780358400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Inferior pancreaticoduodenal artery (IPDA) aneurysms are rare visceral artery aneurysms with high rupture rates and significant mortality. Nonspecific clinical presentation frequently leads to diagnostic delay. We conducted a systematic review to characterize clinical features, diagnostic pitfalls, treatment modalities, and outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review following PRISMA 2020 guidelines was performed. PubMed, Cochrane Library, and Google Scholar were searched from inception through January 2025. Case reports and series describing adult patients with IPDA aneurysms were included. Fisher exact test was used for categorical comparisons. An illustrative fatal index case is presented.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      113 patients from 81 publications were analyzed. Mean age was 60.3 \u00b1 12.0 years with male predominance (62.3%). Rupture occurred in 70.2% of cases. Overall mortality was 9.6% (10\/104). Abdominal pain was the most common presentation (71.7%). Diagnostic pitfall was documented in 47.4% of cases. Celiac axis stenosis was identified in 71.7% of patients. Endovascular treatment was associated with numerically lower mortality than open surgery (3.5% vs 14.3%; OR 0.22; 95% CI: 0.04-1.28;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.08; non-significant). Retroperitoneal hemorrhage predominated among ruptured cases (58.9%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Inferior pancreaticoduodenal artery aneurysms present significant diagnostic challenges due to nonspecific symptoms. High clinical suspicion is warranted in patients with unexplained abdominal pain, particularly those with celiac axis stenosis. A stepwise approach\u2014stabilization, endovascular therapy first, and surgical backup\u2014is endorsed by current guidelines. Multidisciplinary team involvement is essential. Mortality is driven primarily by the systemic consequences of hemorrhagic shock rather than by procedural failure; whether earlier recognition reduces mortality cannot be determined from this data set and warrants prospective study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348261457634","type":"journal-article","created":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T19:06:52Z","timestamp":1780427212000},"page":"3034-3045","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Inferior Pancreaticoduodenal Artery Aneurysms: Diagnostic Challenges and Management Outcomes\u2014A Systematic Review of 113 Cases"],"prefix":"10.1177","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-5374-0376","authenticated-orcid":false,"given":"Rotem","family":"Horowitz","sequence":"first","affiliation":[{"name":"Department of General Surgery, Wolfson Medical Center"},{"name":"Tel Aviv University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shai","family":"Hoffman","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Wolfson Medical Center"},{"name":"Tel Aviv University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moshe","family":"Argaman","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Wolfson Medical Center"},{"name":"Tel Aviv University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronika","family":"Dadaev","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Wolfson Medical Center"},{"name":"Tel Aviv University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waseem","family":"Shakkur","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Wolfson Medical Center"},{"name":"Tel Aviv University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9754-5028","authenticated-orcid":false,"given":"Fahim","family":"Kanani","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Wolfson Medical Center"},{"name":"Tel Aviv University"},{"name":"Department of Transplantation Surgery, Beilinson Hospital, Rabin Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,2]]},"reference":[{"key":"e_1_3_4_2_2","first-page":"45","article-title":"Aneurysm of superior pancreaticoduodenal artery","volume":"24","author":"Ferguson F","year":"1895","unstructured":"Ferguson F. 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