Antibiotic Therapy Did Not Prevent the Rupture of Mycotic Aneurysm of the Superior Mesenteric Artery

2015 ◽  
Vol 18 (3) ◽  
pp. 088
Author(s):  
Ye-tao Li ◽  
Xiao-bin Liu ◽  
Tao Wang
Keyword(s):  
Abdominal Pain ◽  
Infective Endocarditis ◽  
Aortic Valve ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Mycotic Aneurysm ◽  
Acute Abdominal Pain ◽  
Rare Complication ◽  
Emergency Operation ◽  
History Of

<p class="p1"><span class="s1">Mycotic aneurysm of the superior mesenteric artery (SMA) is a rare complication of infective endocarditis. We report a case with infective endocarditis involving the aortic valve complicated by multiple septic embolisms. The patient was treated with antibiotics for 6 weeks. During preparation for surgical treatment, the patient developed acute abdominal pain and was diagnosed with a ruptured SMA aneurysm, which was successfully treated with an emergency operation of aneurysm ligation. The aortic valve was replaced 17 days later and the patient recovered uneventfully. In conclusion, we present a rare case with infective endocarditis (IE) complicated by SMA aneurysm. Antibiotic treatment did not prevent the rupture of SMA aneurysm. Abdominal pain in a patient with a recent history of IE should be excluded with ruptured aneurysm.</span></p>

scholarly journals Superior Mesenteric Artery Syndrome: Clinical and Radiological Considerations

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
M. Ezzedien Rabie ◽  
Olajide Ogunbiyi ◽  
Abdullah Saad Al Qahtani ◽  
Sherif B. M. Taha ◽  
Ahmad El Hadad ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Barium Meal ◽  
Clinical Manifestations ◽  
Rare Condition ◽  
Sma Syndrome ◽  
Ligament Of Treitz ◽  
History Of ◽  
Initial Improvement

Background. Superior mesenteric artery (SMA) syndrome is a rare condition of duodenal obstruction, caused by the overlying SMA.Aim. To report on our experience with the management of SMA syndrome, drawing the attention to its existence.Material and Methods. We reviewed our records to identify cases diagnosed with SMA syndrome, in the period from October 1995 to January 2012.Results. Seven patients were identified, one male and six females. Their mean age was 17.1 years. Vomiting and abdominal pain were the presenting complaints in all patients and history of weight loss was present in six of them. In no patient was the diagnosis suspected initially on clinical grounds. Only after radiological investigations was the diagnosis declared. Radiology took the form of gastrografin/barium meal only in four patients and both gastrografin/barium meal and computerized tomography scan in the remaining three. Four patients responded to medical treatment and surgery was performed in the remaining three, with open duodenojejunostomy in two patients and laparoscopic dissection of the ligament of Treitz in the third. Long lasting improvement was sustained in all patients except one in the surgery group who, despite initial improvement, still has infrequent attacks of abdominal pain.Conclusion. Although the clinical manifestations of SMA syndrome are shared with many other disease entities, it has unique radiological as well as endoscopic features, which enables a confident diagnosis to be made. Once diagnosed, conservative treatment with nutritional support and positioning should be tried first. In case of unresponsiveness, surgery may give a lasting cure.

Endovascular Therapy for Distal Superior Mesenteric Artery Mycotic Aneurysms due to Infective Endocarditis

2019 ◽  
Vol 26 (6) ◽  
pp. 879-884
Author(s):  
Wataru Higashiura ◽  
Hiroaki Takara ◽  
Ryoichi Kitamura ◽  
Tomotaka Iraha ◽  
Akio Nakasu ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Superior Mesenteric Artery ◽  
Transcatheter Arterial Embolization ◽  
Mesenteric Artery ◽  
Mycotic Aneurysm ◽  
Transarterial Embolization ◽  
Arterial Embolization ◽  
Collateral Flow ◽  
Ileocolic Artery ◽  
Mycotic Aneurysms

Purpose: To report 3 patients with infective endocarditis who underwent transcatheter arterial embolization for mycotic aneurysm of the distal superior mesenteric artery (SMA). Case Report: Three men (60, 64, and 65 years old) were diagnosed with infective endocarditis. Antibiotics were initiated immediately after admission and continued for several weeks to months. Distal SMA mycotic aneurysm was identified on computed tomography in the vicinity of the ileocolic artery at 33, 26, and 30 days after admission. In case 1, the ileal artery was occluded distal to the aneurysm, with collateral flow to the ileum. In case 2, the mycotic aneurysm was located below the ileocolic artery, which was stenosed distal to the lesion. In case 3, the aneurysm was located on a branch of the ileal artery. Transarterial embolization using microcoils was successfully performed in all patients. No complications associated with embolotherapy or relapse of infection were observed in these 3 patients at 60, 30, and 15 months, respectively. Conclusion: Transcatheter arterial embolization for distal SMA mycotic aneurysm could provide an alternative to open surgery. Anatomical assessment of collateral flow and preprocedure long-term antibiotic therapy could play important roles in preventing bowel ischemia and minimizing the risk of infection relapse.

Acute Abdominal Pain: Mind the Superior Mesenteric Artery Dissection

2015 ◽  
Vol 49 (5) ◽  
pp. e155-e157 ◽  
Author(s):  
Nicolas de l'Escalopier ◽  
Guillaume Boddaert ◽  
Thomas Erauso ◽  
Emmanuel Hornez
Keyword(s):  
Abdominal Pain ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Acute Abdominal Pain ◽  
Artery Dissection ◽  
Superior Mesenteric Artery Dissection

Endovascular Repair of a Splenic Artery Aneurysm With Anomalous Origin From the Superior Mesenteric Artery

2017 ◽  
Vol 51 (3) ◽  
pp. 152-154 ◽  
Author(s):  
Lalithapriya Jayakumar ◽  
Francis J. Caputo ◽  
Joseph V. Lombardi
Keyword(s):  
Abdominal Pain ◽  
Superior Mesenteric Artery ◽  
Endovascular Repair ◽  
Mesenteric Artery ◽  
Splenic Artery ◽  
Artery Aneurysm ◽  
Recurrent Abdominal Pain ◽  
Anomalous Origin ◽  
Splenic Artery Aneurysm ◽  
History Of

A 22 year old female with a history of recurrent abdominal pain was transferred to our institution with a diagnosis of splenic artery aneurysm identified on imaging. CT angiography of the abdomen and pelvis revealed a partially thrombosed 3.0 cm splenic artery aneurysm without signs of rupture and with an anomalous origin from the superior mesenteric artery. The patient was successfully treated with endovascular exclusion of the aneurysm. Herein we review some of the nuances of endovascular repair of splenic artery aneurysm.

scholarly journals Acute pancreatitis caused by postcholecystectomic pseudoaneurysmatic hemobilia

2019 ◽  
Vol 7 (1) ◽  
pp. 55-57
Author(s):  
Tamzeed Hossain ◽  
Nazmun Nahar Munny ◽  
Chowdhury Rifat Niger ◽  
Hasan Tasmim ◽  
Rawshan Arra Khanam ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Laparoscopic Cholecystectomy ◽  
Obstructive Jaundice ◽  
Gall Bladder ◽  
Superior Mesenteric Artery ◽  
Hepatic Artery ◽  
Mesenteric Artery ◽  
Left Lobe ◽  
History Of

A 50 year old bangladeshi female, came to our emergency with hematemasis ,jaundice and abdominal pain who had a history of laparoscopic cholecystectomy 1 month ago. Patient was diagnosed as acute pancreatitis and obstructive jaundice caused by postcholecystectomic hemobilia. She also had a vascular abnormaly (Her left lobe of liver is supplied by hepatic artery and right love of liver is supplied by accessory hepatic artery which is a branch of superior mesenteric artery, and a sacular aneurysm developed in accessory hepatic artery near the gall bladder fossa (near postcholecystectomy clipping). We are reporting another case of acute pancreatitis after laparoscopic cholecystectomy caused by hemobilia secondary to pseudoaneurysm in accessory hepatic artery originating from superior mesenteric artery. This is probably second such reported case. Bangladesh Crit Care J March 2019; 7(1): 55-57

scholarly journals TRANSIENT ISCHEMIC JEJUNITIS DUE TO SYMPTOMATIC ISOLATED SUPERIOR MESENTERIC ARTERY DISSECTION: CASE REPORT AND REVIEW OF LITERATURE

2016 ◽  
Vol 90 (1) ◽  
pp. 107-112
Author(s):  
Mihaela Mocan ◽  
Ionuț Isaia Jeican ◽  
Mihai Moale ◽  
Romeo Chira
Keyword(s):  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Acute Abdominal Pain ◽  
Rare Condition ◽  
Artery Dissection ◽  
Review Of Literature ◽  
Surgical Department ◽  
Superior Mesenteric Artery Dissection

Acute abdominal pain is one of the most common conditions encountered in the emergency department. The differential diagnosis of acute abdominal pain is extensive and identifying the underlying etiology can be challenging. We report a case of acute transient ischemic jejunitis due to symptomatic isolated superior mesenteric artery dissection in a patient with no cardiovascular risk factors or autoimmune diseases. Symptomatic isolated superior mesenteric artery dissection is a rare cause of acute abdominal pain usually treated in the surgical department. The patient had criteria for conservative treatment and rapidly recovered. We highlight a rare condition which should be taken into account for the differential diagnosis of acute abdominal pain.

scholarly journals A rare cause of acute abdominal pain: spontaneous isolated superior mesenteric artery dissection

2018 ◽  
Vol 5 (7) ◽  
pp. 2623 ◽  
Author(s):  
Georgios Th. Galanopoulos ◽  
Theofanis P. Konstantopoulos ◽  
Ioannis A. Christakis ◽  
Petros Α. Antonopoulos ◽  
Vasilios G. Papavassiliou
Keyword(s):  
Abdominal Pain ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Acute Abdominal Pain ◽  
Epigastric Pain ◽  
Acute Onset ◽  
Artery Dissection ◽  
Intestinal Necrosis ◽  
Nosological Entity ◽  
Superior Mesenteric Artery Dissection

Spontaneous isolated superior mesenteric artery dissection is an extremely rare nosological entity, usually occurring with acute abdominal pain. Authors present the case of a 56 - year - old female with spontaneous isolated SMA dissection who was admitted to the hospital with epigastric pain of acute onset. The patient was successfully managed nonoperatively, with anticoagulation starting immediately after diagnosis. Patient symptoms resolved after a few days. There is a discrepancy concerning the treatment of isolated SMA dissection.  Generally, if there is no intestinal necrosis or SMA rupture, conservative treatment is safe and effective as an initial approach.

scholarly journals Superior mesenteric artery aneurysm in a patient with infective endocarditis

CJEM ◽  
2014 ◽  
Vol 16 (01) ◽  
pp. 84-87 ◽  
Author(s):  
Jennifer Devon ◽  
Philip Miller
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Infective Endocarditis ◽  
Physical Examination ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Artery Aneurysm ◽  
Recent Advances ◽  
Predisposing Conditions

ABSTRACT Infective endocarditis (IE) is a rare but serious condition. We present a case of endocarditis in a healthy 40-year-old male with no predisposing conditions. His physical examination was suggestive of peripheral microembolization and prompted us to consider the diagnosis of IE and order the appropriate investigations. After treatment, he later presented to the emergency department with abdominal pain, and a superior mesenteric artery aneurysm was discovered. We discuss recent advances in the changing epidemiology and microbiology of IE, review the presentation and diagnosis of IE, and highlight the potential complications of this disease.

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