Distal gastrectomy for advanced gastric cancer with vascular anomaly after coronary bypass grafting using the right gastroepiploic artery

Abstract A 77-year-old woman with a history of coronary artery bypass grafting 5 years earlier presented with anemia and was diagnosed with advanced gastric cancer involving the pylorus. Preoperative angiography revealed that the right gastroepiploic artery (RGEA) graft was patent. Multidetector-row...

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Bibliographic Details
Published in:The American journal of surgery 2011-05, Vol.201 (5), p.e35-e37
Main Authors: Kunizaki, Masaki, M.D., Ph.D, Hidaka, Shigekazu, M.D., Ph.D, Nonaka, Takashi, M.D, Takagi, Katsunori, M.D, Tobinaga, Syuichi, M.D, Takeshita, Hiroaki, M.D., Ph.D, Nanashima, Atsushi, M.D., Ph.D, Sawai, Terumitu, M.D., Ph.D, Yasutake, Toru, M.D., Ph.D, Nagayasu, Takeshi, M.D., Ph.D
Format: Article
Language:English
Subjects:
Aged
Anemia
Angiography
Biopsy
Bypass
Cancer
Cardiovascular disease
Classification
Computation
Computed tomography
Coronary artery
Coronary Artery Bypass - methods
Coronary artery bypass grafting
Coronary Artery Disease - complications
Coronary Artery Disease - diagnostic imaging
Coronary Artery Disease - surgery
Coronary vessels
Diagnosis, Differential
Endoscopy, Gastrointestinal
Female
Follow-Up Studies
Gastrectomy
Gastrectomy - methods
Gastric bypass
Gastric cancer
Gastroepiploic Artery - abnormalities
Gastroepiploic Artery - diagnostic imaging
Gastroepiploic Artery - transplantation
Grafting
Heart surgery
Hepatic artery
Humans
Lymph
Lymph nodes
Lymphatic system
Medical imaging
Preservation
Right gastroepiploic artery
Running
Stomach Neoplasms - blood supply
Stomach Neoplasms - complications
Stomach Neoplasms - surgery
Surgery
Vascular Malformations - complications
Vascular Malformations - surgery
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Description
Summary:Abstract A 77-year-old woman with a history of coronary artery bypass grafting 5 years earlier presented with anemia and was diagnosed with advanced gastric cancer involving the pylorus. Preoperative angiography revealed that the right gastroepiploic artery (RGEA) graft was patent. Multidetector-row computed tomography showed the running pattern of the RGEA graft and also revealed a vascular anomaly belonging to type V of Adachi's classification. Adachi's type V is a rare vascular anomaly in which the common hepatic artery originates from the superior mesenteric artery. The patient was treated successfully with a distal gastrectomy and removal of the D2 lymph node with preservation of the RGEA graft. Because of the difficulty in confirming the running pattern of the artery during the surgery, it is important to define the arterial running pattern preoperatively by using multidetector-row computed tomography, including 3-dimensional angiographic imaging.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2010.04.027