1/31. Considerations in the management of aneurysms of the superior mesenteric artery.Aneurysms of the superior mesenteric artery (SMA) are rare, accounting for 5.5% of all splanchnic aneurysms and <0.5% of all intraabdominal aneurysms. Previous reports have characterized these aneurysms among splanchnic artery aneurysms. However, these aneurysms are quite different in terms of etiology, presentation, and treatment, and their independent consideration is warranted. We report a patient with a traumatic SMA aneurysms who was successfully treated with surgical resection and distal revascularization. We also present an alternative technique of retrograde aorto-SMA bypass using autologous vein that prevents kinking. Also included is a review of the recent literature as it pertains specifically to SMA aneurysms.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
2/31. Percutaneous stenting of an latrogenic superior mesenteric artery dissection complicating suprarenal aortic aneurysm repair.PURPOSE: To report endovascular repair of an iatrogenic superior mesenteric artery (SMA) dissection caused by a balloon occlusion catheter. CASE REPORT: A 68-year-old man with a suprarenal aortic aneurysm underwent conventional prosthetic replacement, during which visceral artery back bleeding was controlled with balloon occlusion catheters. Six hours postoperatively, the patient experienced an episode of bloody diarrhea with abdominal pain and tenderness and mild metabolic acidosis. colonoscopy revealed colitis (grade I) without necrosis of the right and left colon. An emergent abdominal computed tomographic scan showed signs of mesenteric ischemia with bowel dilatation and SMA wall hematoma; angiography identified a dissection 1 cm distal to the SMA origin. An Easy Wallstent was deployed percutaneously, successfully reestablishing SMA patency. The postoperative course was uneventful, and the patient remains asymptomatic with a patent SMA stent and aortic graft at 1 year. CONCLUSIONS: latrogenic SMA dissection should be suspected after suprarenal aortic aneurysm repair if signs of mesenteric ischemia arise. Prompt and thorough imaging studies are necessary to confirm the diagnosis and assess the potential for an endoluminal treatment.- - - - - - - - - - ranking = 0.54545454545455keywords = aneurysm (Clic here for more details about this article) |
3/31. Inferior mesenteric artery aneurysm associated with occlusion of the superior mesenteric and celiac arteries.We report a case of a large aneurysm of the inferior mesenteric artery that extended from its origin to bifurcation in the left colic and sigmoidal arteries, and was associated with occlusion of the celiac and superior mesenteric arteries in a 64-year-old patient. The diagnosis was made by arteriography. The patient underwent angioplasty and stenting of the superior mesenteric artery before the operation, which consisted of resection of the aneurysm and reimplantation of the left colic and the sigmoidal arteries separately in the aorta. We believe that this is the first reported case managed by angioplasty in combination with surgery, as well as reimplantation of the branches of the inferior mesenteric artery.- - - - - - - - - - ranking = 0.54545454545455keywords = aneurysm (Clic here for more details about this article) |
4/31. Recurrent nonocclusive mesenteric ischemia after resection of iliac artery aneurysm.A case of recurrent nonocclusive mesenteric ischemia in a patient with isolated internal iliac artery aneurysm penetrating the sigmoid colon is described. On the day after the aneurysm and the sigmoid colon had been resected, the patient developed necrosis of the left hemicolon. Fourteen and nineteen days after left hemicolectomy, massive intestinal bleedings occurred, requiring ileectomy. On the basis of operative findings of good pulsation of visceral arterial branches; angiography showing patent mesenteric vessels with some spasms; and pathological findings suggesting mesenteric ischemia, these ischemic events were diagnosed as nonocclusive mesenteric ischemia. Low-output syndrome induced by massive intestinal bleeding and atrial fibrillation and sepsis were responsible for the establishment of the nonocclusive mesenteric ischemia. Development of disseminated intravascular coagulation and continuous administration of diuretics for acute renal failure seemed to have further perturbed the mesenteric circulation. The patient died of subsequent multiple organ failure 4 months after the first operation. We should pay more attention to nonocclusive mesenteric ischemia in patients with mesenteric ischemia, and strict circulatory management during the perioperative period is essential in these patients.- - - - - - - - - - ranking = 0.54545454545455keywords = aneurysm (Clic here for more details about this article) |
5/31. Superior mesenteric artery pseudoaneurysm successfully treated with polytetrafluoroethylene covered stent.A postoperative superior mesenteric artery pseudoaneurysm that communicates with a pancreatic pseudocyst after aortic surgery is a difficult management problem. Untreated, this condition can lead to exsanguination. Traditional surgical treatment has many potential complications. Endovascular repair has the potential for avoidance of surgical complications. We present the first superior mesenteric artery pseudoaneurysm successfully treated with A polytetrafluorethylene covered stent.- - - - - - - - - - ranking = 0.64928228674337keywords = aneurysm, pseudoaneurysm (Clic here for more details about this article) |
6/31. diagnosis and management of aneurysms involving the superior mesenteric artery and its branches--a report of four cases.Aneurysms of the superior mesenteric artery (SMA) are an uncommon but lethal entity, which must be treated expeditiously to avoid mortality and high incidence of ischemic small bowel complications. In the past 7 years the authors have treated 4 patients with a variety of types of aneurysms involving the SMA and its branches at a university-based teaching hospital. The first was a mycotic SMA aneurysm as a result of septic mitral valve, the second a jejunal aneurysm in a patient with pancreatitis, the third a spontaneous dissection distal to a small SMA aneurysm with thrombus partially occluding the distal vessel, and the fourth an SMA aneurysm associated with the diagnosis of mesenteric insufficiency. All patients presented with abdominal pain. The diagnosis was made initially in 1 patient on plain abdominal films with a calcified aneurysm, on duplex scan in the second, and on computed tomography (CT) scans in the remaining 2. Treatment consisted of bowel resection and ligation of mycotic aneurysm in the first patient, of catheter embolization of jejunal aneurysm in the patient with pancreatitis, and of vein graft bypass in the patient with a large SMA aneurysm. The patient with SMA aneurysm and distal dissection with partially occluding thrombus received anticoagulation and is being followed up with serial CT scans. There were no deaths. One patient required bowel resection, which did not result in short gut syndrome. Improved abdominal duplex scanning and CT technology facilitates the diagnosis of mesenteric aneurysm. The broad spectrum of etiologies mandates that treatment be tailored to the individual patient, and it varies from endovascular techniques to traditional bypass surgery. Prompt diagnosis and treatment results in the lowest mortality rate and minimizes the prevalence of intestinal infarction.- - - - - - - - - - ranking = 1.3636363636364keywords = aneurysm (Clic here for more details about this article) |
7/31. Inferior mesenteric artery aneurysm: case report and review of the literature.Aneurysms of the inferior mesenteric artery are very rare. We report a new case associated with aorto-iliac occlusive disease and occlusion of the superior mesenteric artery, as well as review the pertinent literature.- - - - - - - - - - ranking = 0.36363636363636keywords = aneurysm (Clic here for more details about this article) |
8/31. Surviving gastrointestinal infarction due to polyarteritis nodosa: a rare event.Poly arteritis nodosa (PAN) is a systemic vasculitis with a male: female ratio of 2:1 and a peak incidence in the fifth decade. Small to medium-sized arteries are involved by focal transmural inflammatory necrosis. Aneurysms with inflammatory destruction of the media also occur. The most frequently involved organs are the kidney, heart, lung, liver, and gastrointestinal tract. There are few reported cases of ischemic necrosis of the intestine and even fewer survivors. A 22-year-old woman was transferred to St. Thomas Hospital (Nashville, TN) after resection of 80 per cent of the small bowel for ischemic necrosis. She had a history of juvenile onset diabetes mellitus, recurrent abdominal pain, and splinter hemorrhages. Emergency aortogram and selective mesenteric arteriogram were performed. The celiac artery was not visualized and small aneurysms were present in the mesenteric and renal arteries. The patient was successfully resuscitated from a cardiac arrest in x ray from a cardiac tamponade. laparotomy was performed to determine the viability of the bowel. The celiac, hepatic, and splenic arteries were found to be chronically occluded. pathology of these arteries revealed a nonspecific arteritis. At a third operation, several more inches of small bowel were removed. Characteristic changes of PAN were present on all small bowel specimens. She was treated with high-dose cyclophosphamide and steroids for 6 months and has continued on low-dose cyclophosphamide. She is now 36 months from her original operation and is doing well on oral nutrition. Intestinal hemorrhage from aneurysm rupture or gangrene with perforation are gastrointestinal complications of PAN that the surgeon may be called upon to treat.(ABSTRACT TRUNCATED AT 250 WORDS)- - - - - - - - - - ranking = 0.18181818181818keywords = aneurysm (Clic here for more details about this article) |
9/31. Aneurysm of superior mesenteric vein: case report with 5-year follow-up and review of the literature.Venous aneurysms are less common than arterial aneurysms in clinical practice, and the occurrence of isolated cases is a topic for publication. Aneurysms of the superior mesenteric vein are rare, and their origin is unknown. Many aneurysms are asymptomatic, and the diagnosis is established from radiologic findings. Others are diagnosed after complications such as gastrointestinal bleeding or thrombosis with associated abdominal pain. Because of the rarity of this disease and consequent absence of standard treatment, therapy must be adapted to fit each case. We present a case report of an aneurysm of the superior mesenteric vein. The diagnosis of this anomaly was made after investigation of abdominal pain. Computed tomography (CT) scans demonstrated the mass. Clinical treatment was administered, and no aneurysm growth was observed after 5 years of follow-up.- - - - - - - - - - ranking = 0.45454545454545keywords = aneurysm (Clic here for more details about this article) |
10/31. thrombosis of a superior mesenteric vein aneurysm: transarterial thrombolysis and transhepatic aspiration thrombectomy.We report the case of a 31-year-old woman presenting with abdominal pain due to acute thrombosis of a superior and inferior mesenteric vein aneurysm, which was treated by a combination of arterial thrombolysis and transhepatic thrombus aspiration. At the last follow-up CT, 21 months following this procedure, there was no evidence of rethrombosis, and the patient continues to do well under oral anticoagulation. The literature regarding these uncommon mesenteric vein aneurysms without portal vein involvement, as well as their treatment options, is reviewed.- - - - - - - - - - ranking = 0.54545454545455keywords = aneurysm (Clic here for more details about this article) |
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