Fig. 2

A, B non-contrast axial and coronal computed tomography scan show a huge hetero-dense mass in the sub-hepatic region, near to the head of the pancreas and medial to the cecum (yellow hollow arrow), with focal bulging at its medial margin (yellow cross star) and peripheral calcification and marginal hyper-dense crescent-like foci (short yellow arrows) suggestive of probably an aneurysm with hyperdense crescent sign. C Abdominal computed tomography scan Topogram: curvilinear calcification is visible mainly at right side of thoracolumbar spine in the sub-hepatic region. D Sagittal plane of computed tomography angiography, reveals an aneurysm with mural thrombosis (red cross star) and its patent lumen (red arrowhead) originating from the posterior and inferior surface of the proximal of the superior mesenteric artery (short arrow). The origin of the celiac trunk (dotted circle) is significantly narrowed due to the compressive effect of thickened diaphragmatic crura (long arrow). E, F Coronal plane of computed tomography angiography shows considerable compressive effect of huge aneurysm on the cecum, D2 and D3 portions of the duodenum (short yellow arrows) and common bile duct (small yellow star). A thrombus fissuration sign (long yellow arrow) is an extension of contrast from the patent lumen to the mural thrombus. The red arrowhead points to the another aneurysm, located at the superior margin of the giant aneurysm. The orange dashed line shows the slightly irregular liver’s margin. G Portal vein (small red star) and dilated common bile duct and are visible on the axial plane in the porta-hepatis region. The gallbladder is shown by the large star. The pylorus and D1 portion of the duodenum are indicated by the small yellow arrow. A yellow dashed line represents mild dilatation of the main pancreatic duct. The celiac trunk's origin has narrowed significantly (dotted circle). The red cross star represents the spleen. H, I The yellow cross stars indicate focal bulging and discontinuous calcification at the medial and lateral margins of the huge aneurysm. Mild fat stranding is present, adjacent to medial margin of the aneurysm. J The axial scan just inferior to "G". Gastroduodenal artery (GDA) is shown by short yellow arrow. Two aneurysms originating from the posterior branch of GDA (posterior superior pancreaticoduodenal artery) are depicted by the red arrowheads. (K, L) The central intrahepatic bile ducts are mildly dilated. The anterior periportal space is widened