138 J ENDOVASC THER 2005;12:138–141  2005 by the INTERNATIONAL SOCIETY OF ENDOVASCULAR SPECIALISTS Available at www.jevt.org  CASE REPORT  Endovascular Repair of Traumatic Aortic Pseudoaneurysm With Associated Celiacomesenteric Trunk Tej M. Singh, MD 1 ; Raymund Hung, MD 2 ; Edward Lebowitz, MD 2 ; Agnes Wallbom, MD 3 ; Debbie Shaver 4 ; Jaime Soria, PA 1 ; and Christopher K. Zarins, MD 5 1 Division of Vascular and Endovascular Surgery, 2 Division of Interventional Radiology, and 3 Department of Rehabilitation, Santa Clara Valley Medical Center, San Jose, California, USA. 4 Medtronic, Santa Rosa, California, USA. 5 Division of Vascular Surgery, Stanford University, Stanford, California, USA.   Purpose: To report stent-graft repair of a traumatic aortic pseudoaneurysm in proximity to a celiacomesenteric trunk. Case Report: An 18-year-old woman suffered a large gunshot wound to the right flank. At laparotomy, only a large, nonexpanding right retroperitoneal hematoma was found, which was thought to represent significant penetrating trauma to the kidney mass. The patient was monitored in the intensive care unit. One week later, computed tomography revealed a partially infarcted right kidney and a 2.3-cm supraceliac aortic pseudoaneurysm, with adjacent bullet fragments. An angiogram confirmed the pseudoaneurysm and showed it to be 7 mm from the celiacomesenteric trunk. Endovascular repair was undertaken with a 1655-mm AneuRx stent-graft, which was successfully placed across the aortic pseudo- aneurysm without covering the celiacomesenteric trunk. Imaging at 12 months revealed no endoleak and full pseudoaneurysm exclusion. Conclusions: This operative approach is appropriate for the individual patient who has suitable anatomy and a clinical course that requires immediate repair of an aortic injury to prevent further complications and delays in ancillary treatments. J Endovasc Ther 2005;12:138–141 Key words: trauma, pseudoaneurysm, aorta, celiacomesenteric trunk, endovascular repair, stent-graft   Address for correspondence and reprints: Tej M. Singh, MD, Division of Vascular Surgery, SantaClara Valley Medical Center, 751 S. Bascom Avenue, San Jose, CA 95128 USA. Fax: 1-408-885-2120; E-mail: tej.singh@hhs.co.santa-clara.ca.us Open surgical repair of supraceliac aortic an- eurysms and pseudoaneurysms is a difficult procedure with significant operative morbid- ity and mortality. 1–4 Most operations are per- formed with significant morbidity and mor- tality given the location of the injuries and the associated injuries at the time of repair. 5–7 While endovascular repair of aortic pseudo- aneurysms has been described, 8–14 most cas- es have involved injuries in the proximal tho- racic aorta. Endovascular repair of the abdominal aorta proximal to the celiac artery is limited by concerns of celiac artery cover- age and possible visceral/hepatic ischemia. Celiacomesenteric trunk 15 is a rare congen- ital finding in which the celiac artery and su- perior mesenteric artery (SMA) arise from a common trunk, usually at the level of L1. The