Rapid progression of multiple splanchnic artery aneurysms.

THAT INCLUDED LONG-STANDING MUSCULAR DYSTROPHY presented with moderate-to-severe epigastric and mid-back pain. Family history was noncontributory. The patient worked as a full-time computer instructor. He was a social drinker and denied a history of cigarette smoking or illicit drug use. At initial presentation, vital signs were normal except for a blood pressure of 148/105 mm Hg. Physical examination revealed moderate epigastric tenderness without rebound or guarding. Laboratory findings were unremarkable, and the hemoglobin was 12.4 g/dL (hematocrit, 37%). A computed tomography of the abdomen and pelvis demonstrated a retroperitoneal hemorrhage that involved the mesenteric circulation. A mesenteric arteriogram (Fig 1) was performed that revealed high-grade stenosis of the celiac artery origin with retrograde filling via superior mesenteric artery (SMA) collaterals as well as aneurysms of the celiac artery trifurcation and inferior pancreaticoduodenal artery (IPDA)