Mini-Laparotomy for Superior Mesenteric Artery Aneurysm Due to Takayasu's Arteritis

Superior mesenteric artery aneurysm (SMAA) is reported to be the third-most common type of visceral aneurysm (VA), accounting for 5% of all VAs. The etiology of SMAA is commonly thought to be infection, and it usually exists in the proximal part of the superior mesenteric artery, which is suitable for endovascular treatment. We herein report an extremely rare case of the distal part of SMAA caused by Takayasu's arteritis (TA), which was successfully resected using a mini-laparotomy method without impairing the intestinal blood supply. A 51-year-old woman was admitted to our hospital with sustained fever and lower back pain. Physical examination showed that she had a discrepancies in blood pressure between both arms. Contrast-enhanced whole-body computed tomography showed stenosis of the thoracic aorta and an aneurysm located in the distal part of the superior mesenteric artery. The diameter of the aneurysm was 4.5 cm. The aneurysm was resected via 4-cm mini-laparotomy, and the vascularity of the intestine was successfully preserved. The postoperative course was uneventful, and the patient was diagnosed as having TA based on both clinical and pathologic findings. Additional corticosteroid therapy was started to treat the arteritis, and at 3-month follow-up she was without critical incidents. Mini-laparotomy is a safe and less-invasive approach to treat SMAA, especially when the lesion is located in the distal part of the artery.

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Takayasu's Arteritis-associated Superior Mesenteric Artery Aneurysm Treated by Stent-graft Implantation via the Common Carotid Artery

European Journal of Vascular and Endovascular Surgery ◽

10.1016/j.ejvs.2013.05.014 ◽

2013 ◽

Vol 46 (3) ◽

pp. 393

Author(s):

H.Y. Zhang ◽

D.Z. Chai ◽

W.G. Fu ◽

Y.Q. Wang ◽

J. Yang ◽

...

Keyword(s):

Carotid Artery ◽

Superior Mesenteric Artery ◽

Stent Graft ◽

Common Carotid Artery ◽

Mesenteric Artery ◽

Takayasu’S Arteritis ◽

Artery Aneurysm ◽

The Common ◽

Stent Graft Implantation ◽

Graft Implantation

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Takayasu's Arteritis-associated Superior Mesenteric Artery Aneurysm Treated by Stent-graft Implantation via the Common Carotid Artery

EJVES Extra ◽

10.1016/j.ejvsextra.2013.05.002 ◽

2013 ◽

Vol 26 (3) ◽

pp. e30-e31

Author(s):

H.Y. Zhang ◽

D.Z. Chai ◽

W.G. Fu ◽

Y.Q. Wang ◽

J. Yang ◽

...

Keyword(s):

Carotid Artery ◽

Superior Mesenteric Artery ◽

Stent Graft ◽

Common Carotid Artery ◽

Mesenteric Artery ◽

Takayasu’S Arteritis ◽

Artery Aneurysm ◽

The Common ◽

Stent Graft Implantation ◽

Graft Implantation

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Visceral Mycotic Aneurysm: Superior Mesenteric Artery Aneurysm Caused by K. pneumoniae

Dubai Medical Journal ◽

10.1159/000517222 ◽

2021 ◽

pp. 1-4

Author(s):

Reham Almasoud ◽

Alaaeddin Nwilati ◽

Saeb Bayazid ◽

Mamoun Shafaamri

Keyword(s):

Infectious Disease ◽

Antibiotic Therapy ◽

Superior Mesenteric Artery ◽

Mesenteric Artery ◽

Mycotic Aneurysm ◽

Artery Aneurysm ◽

Management Plan ◽

Resected Tissue ◽

Infectious Disease Specialists

We herein report a rare case of mycotic aneurysm of the superior mesenteric artery caused by <i>Klebsiella pneumoniae</i>. A 66-year-old man, a known case of hypertension and aorto-oesophageal fistula with stented aorta in 2010 and 2018, presented to the emergency department multiple times over 2 months with severe postprandial abdominal pain associated with vomiting and fever. On his last presentation, the obtained blood cultures grew ESBL positive <i>K. pneumoniae</i> and a repeated computed tomography (CT) showed a growing aneurysm at the origin of the ileocecal branch of the superior mesenteric artery measuring 17 × 10 mm (the aneurysm was 8 × 7.5 mm in the CT angiography on the previous admission). Extensive workup did not reveal the underlying cause of the mycotic aneurysm, thus we believe the cause to be the infected aortic stent, leading to bacteraemia and vegetations to the mesenteric artery causing the aneurysm. The management plan was placed by a multidisciplinary team consisting of vascular surgeons and infectious disease specialists along with review from a dietician to evaluate the patient’s nutritional status. The patient was started on total parenteral nutrition due to his postprandial pain and on antibiotic therapy according to the infectious disease team’s recommendation. He underwent surgical resection of the mycotic aneurysm, which showed a thrombosed aneurysm in the jejunoileal mesenteric area. The histopathology of the resected tissue demonstrated inflammatory aneurysm of the mesenteric artery. Following the surgery, the patient continued his antibiotic therapy and was discharged on the 13th post-operative day with follow-up appointments in the vascular surgery and infectious disease clinic.

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Anomalous splenic artery aneurysm

Vascular ◽

10.1177/1708538113478717 ◽

2013 ◽

Vol 21 (2) ◽

pp. 105-108 ◽

Cited By ~ 5

Author(s):

Sydney S N Wong ◽

T F Lindsay ◽

G Roche-Nagle

Keyword(s):

Superior Mesenteric Artery ◽

Surgical Resection ◽

Surgical Management ◽

Mesenteric Artery ◽

Splenic Artery ◽

Artery Aneurysm ◽

Anomalous Origin ◽

Splenic Artery Aneurysm ◽

Visceral Aneurysm ◽

Preservation Of The Spleen

Aneurysms of the splenic artery are the most common visceral aneurysm. A splenomesenteric trunk, which involves the splenic artery arising from the superior mesenteric artery (SMA), is rare and occurs in less than 1% of patients. Thus splenic artery aneurysms (SAAs) with an anomalous origin from the SMA are quite rare. We report our experience with the surgical management of a 2.6-cm aneurysm involving a splenic artery arising from the SMA in a 40-year-old woman. This was treated with surgical resection with preservation of the spleen. A discussion about SAAs and the management of aneurysms arising from a splenomesenteric trunk follows.

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