scholarly journals 905 Inferior Mesenteric Artery Branch Aneurysm Causing Ischemic Colitis – A Sequela of Anabolic Steroid Use

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
S Joshi ◽  
M Sebastian ◽  
A Koshy
Keyword(s):  
Anabolic Steroid ◽  
Ischemic Colitis ◽  
Mesenteric Artery ◽  
Inferior Mesenteric Artery ◽  
Bowel Function ◽  
Acute Onset ◽  
Vascular Pathology ◽  
Visceral Artery ◽  
Valuable Insight ◽  
Visceral Artery Aneurysms

Abstract An inferior mesenteric artery (IMA) aneurysm comprises less than 1% of all reported visceral artery aneurysms. A 34-year-old bodybuilder with a history of anabolic steroid (AS) use of unknown duration, dose and frequency initially presented to the hospital with recurrent bouts of acute onset abdominal pain and alternating episodes of watery-mucous diarrhoea and constipation. Patient’s medical history was otherwise unremarkable with no stigmata of any connective tissue disorders. A diagnosis of ischemic colitis secondary to a distal IMA branch aneurysm measuring 6mm x 5mm x 10mm on CT was made three years after first presentation. Flexible sigmoidoscopy confirmed mucosal changes consistent with sigmoid ischemic colitis. A robotic anterior resection was performed due to two failed attempts at coiling the aneurysm. The histology was consistent with a secondary fibromuscular dysplasia in the IMA and its branches. There was a resolution of symptoms and return to normal stool and bowel function post-operatively. The commonest cause of an IMA aneurysm is the “jet disorder” phenomenon caused by incomplete atherosclerotic occlusion of the superior mesenteric (SMA) and celiac arteries (CA). While the link between AS use and dyslipidaemia is established, the patient’s lipid profile was normal. We believe this case lends valuable insight into atypical causes of ischemic colitis and adds to the literature on AS use and vascular pathology.

scholarly journals An inferior mesenteric artery aneurysm in a patient with renal cell carcinoma

2020 ◽  
Vol 28 (4) ◽  
pp. 680-683
Author(s):  
Bülent Mert
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Mesenteric Artery ◽  
Inferior Mesenteric Artery ◽  
Left Kidney ◽  
Artery Aneurysm ◽  
Visceral Artery ◽  
Left Renal Artery ◽  
Visceral Artery Aneurysms

An inferior mesenteric artery aneurysm is considered one of the visceral artery aneurysms, which is extremely rare, although its incidence of detection has been increasing in recent years. A 59-year-old male patient with a renal cell carcinoma in the left kidney was diagnosed with an inferior mesenteric artery aneurysm and treated surgically. Computed tomography revealed atrophy of the right kidney and occlusion of the celiac trunk, superior mesenteric artery, and left renal artery. There were no complications during the hospital stay and no mortality or morbidity was observed at three months of follow-up. In conclusion, the treatment of inferior mesenteric artery aneurysms is usually recommended, due to possible complications such as rupture and thromboembolism with high mortality and morbidity rates.

scholarly journals Current management strategies for visceral artery aneurysms: an overview

Surgery Today ◽  
2019 ◽  
Vol 50 (1) ◽  
pp. 38-49 ◽  
Author(s):  
Hideaki Obara ◽  
Matsubara Kentaro ◽  
Masanori Inoue ◽  
Yuko Kitagawa
Keyword(s):  
Mesenteric Artery ◽  
Management Strategies ◽  
Hybrid Approach ◽  
Celiac Artery ◽  
Visceral Artery ◽  
Anatomical Location ◽  
Current Management ◽  
Risk Of Rupture ◽  
Visceral Artery Aneurysms ◽  
History Of

Abstract Visceral artery aneurysms (VAAs) are rare and affect the celiac artery, superior mesenteric artery, and inferior mesenteric artery, and their branches. The natural history of VAAs is not well understood as they are often asymptomatic and found incidentally; however, they carry a risk of rupture that can result in death from hemorrhage in the peritoneal cavity, retroperitoneal space, or gastrointestinal tract. Recent advances in imaging technology and its availability allow us to diagnose all types of VAA. VAAs can be treated by open surgery, laparoscopic surgery, endovascular therapy, or a hybrid approach. However, there are still no specific indications for the treatment of VAAs, and the best strategy depends on the anatomical location of the aneurysm as well as the clinical presentation of the patient. This article reviews the literature on the etiology, clinical features, diagnosis, and anatomic characteristics of each type of VAA and discusses the current options for their treatment and management.

scholarly journals A case of ischemic colitis due to the embolization therapy of inferior mesenteric artery aneurysm

2016 ◽  
Vol 89 (1) ◽  
pp. 140-141
Author(s):  
Shigeyuki Kamata ◽  
Fumihiko Ishikawa ◽  
Hiroshi Nitta ◽  
Yoshihisa Fujita ◽  
Chizu Yamada ◽  
...  
Keyword(s):  
Ischemic Colitis ◽  
Mesenteric Artery ◽  
Inferior Mesenteric Artery ◽  
Artery Aneurysm ◽  
Embolization Therapy

scholarly journals Visceral Artery Aneurysms: Decision Making and Treatment Options in the New Era of Minimally Invasive and Endovascular Surgery

2019 ◽  
Vol 28 (01) ◽  
pp. 011-016 ◽  
Author(s):  
Jun Xu ◽  
Mel Sharafuddin ◽  
John Corson ◽  
Maen Hosn
Keyword(s):  
Mesenteric Artery ◽  
Incidental Finding ◽  
Treatment Options ◽  
Current Treatment ◽  
Celiac Artery ◽  
Visceral Artery ◽  
Management Guidelines ◽  
New Era ◽  
Visceral Artery Aneurysms ◽  
Arterial Aneurysms

AbstractThe abdominal viscera blood supply is derived from anterior branches of the abdominal aorta. Visceral artery aneurysms (VAAs) include aneurysms of the following arteries and their branches: the celiac artery, the hepatic artery, the splenic artery, the superior mesenteric artery, the inferior mesenteric artery, the pancreaticoduodenal artery, and the gastroduodenal artery. Overall VAAs comprise < 2% of all types of arterial aneurysms. Asymptomatic VAAs are now being encountered more frequently due to the widespread use of advanced diagnostic abdominal imaging. The incidental finding of a VAA frequently leaves clinicians with a dilemma as to the best course of management. The focus of this review is on current treatment options and management guidelines for both symptomatic and asymptomatic VAAs.

Rupture prone aneurysm of the inferior mesenteric artery complicated by mid aortic syndrome with occluded celiac and superior mesenteric arteries

VASA ◽  
2011 ◽  
Vol 40 (1) ◽  
pp. 73-77 ◽  
Author(s):  
Werth ◽  
Rodionov ◽  
Hinterseher ◽  
Beyer-Westendorf ◽  
Stroszczynski ◽  
...  
Keyword(s):  
Mesenteric Artery ◽  
Inferior Mesenteric Artery ◽  
Bypass Graft ◽  
Celiac Trunk ◽  
Mesenteric Arteries ◽  
Vascular Pathology ◽  
Vein Bypass ◽  
Large Aneurysm ◽  
Vein Bypass Graft ◽  
Saphenous Vein Bypass Graft

We present the case of a 45-year-old male patient with a large aneurysm of the inferior mesenteric artery complicated by mid aortic syndrome with occlusion of the celiac trunk and superior mesenteric artery. The vascular pathology was detected by CT imaging after presentation and hospitalization with symptoms of acute cholecystitis. After resolve of the acute symptoms, the aneurysm was resected and the proximal inferior mesenteric artery interponated with a reversed saphenous vein bypass graft. Besides presenting this case we review the literature concerning the rare descriptions of inferior mesenteric artery aneurysms.

Visceral Artery Aneurysms: A Symptomatic Aneurysm of the Ileocolic Artery

Vascular ◽  
2007 ◽  
Vol 15 (3) ◽  
pp. 162-166
Author(s):  
Graham Roche-Nagle ◽  
David O'Donnell ◽  
Timothy O'Hanrahan
Keyword(s):  
Mortality Rate ◽  
Incidental Findings ◽  
Artery Aneurysm ◽  
Vascular Pathology ◽  
Visceral Artery ◽  
Visceral Artery Aneurysm ◽  
Ileocolic Artery ◽  
Visceral Artery Aneurysms ◽  
Therapeutic Procedures ◽  
Important Form

Visceral artery aneurysm is a rare but clinically important form of vascular pathology, showing a high mortality rate in emergency surgery. Most often these aneurysms cause no symptoms and are therefore incidental findings. Reports on ileocolic artery aneurysms are rare and often anecdotal. Therapeutic procedures can be performed either surgically or by interventional therapeutic techniques. This article presents a case of ruptured ileocolic artery aneurysm and reviews the literature on this topic.

Incidence, morbidity, and mortality of traumatic superior mesenteric artery injuries compared to other visceral arteries

Vascular ◽  
2019 ◽  
Vol 28 (2) ◽  
pp. 142-151
Author(s):  
Shelley Maithel ◽  
Areg Grigorian ◽  
Roy M Fujitani ◽  
Nii-Kabu Kabutey ◽  
Brian M Sheehan ◽  
...  
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Inferior Mesenteric Artery ◽  
Celiac Artery ◽  
Visceral Artery ◽  
Trauma Patients ◽  
Mechanism Of Injury ◽  
Artery Injury ◽  
Risk Of Mortality ◽  
Increased Risk

Objectives Celiac artery, superior mesenteric artery, and inferior mesenteric artery injuries are often grouped together as major visceral artery injuries with an incidence of <1%. The mortality rates range from 38–75% for celiac artery injuries and 25–68% for superior mesenteric artery injuries. No large series have investigated the mortality rate of inferior mesenteric artery injuries. We hypothesize that from all the major visceral artery injuries, superior mesenteric artery injury leads to the highest risk of mortality in adult trauma patients. Methods The Trauma Quality Improvement Program (2010–2016) was queried for patients with injury to the celiac artery, superior mesenteric artery, or inferior mesenteric artery. A multivariable logistic regression model was used for analysis. Separate subset analyses using blunt trauma patients and penetrating trauma patients were performed. Results From 1,403,466 patients, 1730 had single visceral artery injuries with 699 (40.4%) involving the celiac artery, 889 (51.4%) involving the superior mesenteric artery, and 142 (8.2%) involving the inferior mesenteric artery. The majority of patients were male (79.2%) with a median age of 39 years old, and median injury severity score of 22. Compared to celiac artery and inferior mesenteric artery injuries, superior mesenteric artery injuries had a higher rate of severe (grade >3) abbreviated injury scale for the abdomen (57.5% vs. 42.5%, p < 0.001). The overall mortality for patients with a single visceral artery injury was 20%. Patients with superior mesenteric artery injury had higher mortality compared to those with celiac artery and inferior mesenteric artery injuries (23.7% vs. 16.3%, p < 0.001). After controlling for covariates, traumatic superior mesenteric artery injury increased risk of mortality (OR = 1.72, CI = 1.24–2.37, p < 0.01) in adult trauma patients, while celiac artery ( p = 0.59) and inferior mesenteric artery ( p = 0.31) injury did not. After stratifying by mechanism, superior mesenteric artery injury increased risk of mortality (OR = 3.65, CI = 2.01–6.45, p < 0.001) in adult trauma patients with penetrating mechanism of injury but not in those with blunt force mechanism (OR = 1.22, CI = 0.81–1.85, p = 0.34). Conclusions Compared to injuries of the celiac artery and inferior mesenteric artery, traumatic superior mesenteric artery injury is associated with a higher mortality. Moreover, while superior mesenteric artery injury does not act as an independent risk factor for mortality in adult patients with blunt force trauma, it nearly quadruples the risk of mortality in adult trauma patients with penetrating mechanism of injury. Future prospective research is needed to confirm these findings and evaluate factors to improve survival following major visceral artery injury.

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