Emergency Pancreatoduodenectomy with Preservation of Gastroduodenal Artery for Massive Gastrointestinal Bleeding due to Duodenal Metastasis by Clear Cell Renal Cell Carcinoma in a Patient with Celiac Artery Stenosis
(a) Selective catheterization of SMA, showing hypertrophic inferior pancreatoduodenal arteries supplying through the GDA the proper hepatic artery and right and left hepatic arteries. Coils in posterior inferior pancreaticoduodenal artery. (b) CT scan (arterial phase). Stenosis at the origin of the celiac artery with poststenotic dilatation (arrows). Cross-sectional images illustrated the sizeable bilateral adrenal metastases.