Mycotic aneurysm of the superior mesenteric artery

The superior mesenteric artery is a frequent site of mycotic aneurysm formation. With the increasing popularity of parenteral drug abuse the incidence of superior mesenteric aneurysms is likely to increase. It should be suspected in any patient who has a history of bacterial endocarditis, sepsis, and abdominal pain. Abdominal CT scanning and visceral angiography are most useful in establishing the diagnosis, and surgical therapy should ensue with minimal delay. The various intraoperative methods of eradicating this lesion are described, with a review of the literature and report of successful management of one such case.     

Five-centimeter superior mesenteric artery aneurysm. A case report

An unusual large mesenteric artery aneurysm presented as "angina abdominis" and abdominal mass is described. Endoaneurismectomy with reverse end-to-end saphenous vein graft was performed. The incidence, pathogenesis and diagnosis are reviewed and the treatment is discussed.     

Mycotic aneurysm of the celiac trunk and superior mesenteric artery in a case of infective endocarditis

Mycotic aneurysms of the celiac artery are extremely rare, and in our review of the literature we found that in only one case was it due to infective endocarditis. In our case a 19-year-old female patient with culture-negative infective endocarditis presented with pain in the epigastric area. A celiac artery aneurysm was diagnosed by ultrasonography and confirmed on CT scan and angiography, which also demonstrated an associated aneurysm of the superior mesenteric artery. Since excellent collateral circulation was present, simple ligation of the two aneurysms was performed. The patient presented no major complications in the postoperative course.     

An isolated dissecting: aneurysm of the superior mesenteric artery: report of a case

We report herein the case of a 56-year-old man found to have an isolated dissecting aneurysm of the superior mesenteric artery (SMA) after he presented with a 3-day history of postprandial epigastralgia of sudden onset. An echogram showed marked dilatation of the SMA and a high level of peripheral echoes in a linear fashion within its lumen. A thin-section contrast enhanced computed tomography revealed a thin flap, separating two distinct well-enhanced lumina. Angiography confirmed the presence of a localized dissecting aneurysm of the SMA. The patient was treated conservatively and has since been followed up as an outpatient. Following the presentation of this case, the problems regarding the diagnosis and management of this rare disease are discussed based on a review of the literature.     

Mycotic aneurysm of the inferior mesenteric artery

This is the first reported case of successful management of a mycotic aneurysm of the inferior mesenteric artery. The only helpful clinical manifestations were episodes of previous abdominal pain and a history of bacterial endocarditis. The surgical management involved simple excision without revascularization of the inferior mesenteric artery.     

Common hepatic artery aneurysm branching from the superior mesenteric artery. Report of a case

A 58-year-old man was notified as having a mass in the head of the pancreas at medical checkup on September 26, 2000. He was admitted to our department after being diagnosed as having an aneurysm in the common hepatic artery, branching from the superior mesenteric artery (SMA), based on selective SMA angiography. From an abdominal midline incision, we were able to reach his common hepatic artery aneurysm (CHAA) by mobilizing the pancreas through the route lateral to the greater curvature of the stomach. This aneurysm arose in the common hepatic artery immediately after branching from the SMA. After proximal and distal control of the SMA and common hepatic artery, the aneurysm was incised and the distal hepatic artery was anastomosed end to side to the SMA. The patient had an uneventful postoperative course.     

Mycotic aneurysm in a digital artery: case report and literature review

A mycotic aneurysm of the common digital artery at its junction with the palmar arch, extending into the ulnar proper digital artery of the index finger, is reported in a patient with endocarditis. A review of the English-language literature revealed no case of mycotic aneurysm in a digital artery. Diagnosis of the aneurysm was established noninvasively by ultrasound. Because this patient lacked a radial proper digital artery to the finger, the aneurysm was managed by excision and revascularization with a bypass graft from the long finger. Postoperative circulatory monitoring was facilitated by a pulse oximeter.     

Mycotic aneurysm of the thoracic aorta as a late complication of umbilical artery catheterization. A case report

A case of mycotic thoracic pseudoaneurysm as a late complication of umbilical artery catheterization and septicaemia is presented. Thoracic pseudoaneurysm should be suspected when a child with mediastinal tumour has a history of neonatal umbilical artery catheterization complicated by septicaemia. The diagnosis should be established by CT-scanning, aortography or operation.     

Mycotic aneurysm of the superior gluteal artery in a patient with bacterial endocarditis: case report and review of the literature

Mycotic aneurysm of the superior gluteal artery (SGA) is extremely rare. The review of the literature revealed only five cases of mycotic SGA aneurysms reported to date and none had a concomitant superior mesenteric artery (SMA) aneurysm. We describe a 64-year-old man with mycotic aneurysms of both the SGA and the SMA. The patient was referred to our hospital because of SMA embolism caused by bacterial endocarditis following mitral valve plasty. He was treated conservatively, but monitoring using computerized tomography (CT) scanning showed the development and growth of the SGA and the SMA aneurysms. The SMA aneurysm was resected surgically, and the SGA lesion was treated by means of selective embolization. For the treatment of SGA aneurysms, prompt and precise preoperative evaluation is important. When the anatomical feature and size of the aneurysm is suitable, endovascular treatment may be the first-line treatment, providing an efficacious and safe alternative to traditional surgical repair.     

Mycotic abdominal aortic aneurysm: a case report

A case of mycotic aneurysm of the abdominal aorta, arising as a complication of subacute bacterial endocarditis in a 75-year-old white woman, is presented. The dramatically expansile nature of this aneurysm is well documented. The history, clinical presentation, etiology, microbiology and surgical management of this rapidly progressive and often fatal condition are discussed through a review of the literature.     

Laparoscopic duodenojejunostomy for superior mesenteric artery syndrome: report of a case

Vascular compression of the duodenum is also known as superior mesenteric artery syndrome (SMA syndrome) or Wilkie syndrome. This is a rare condition that is characterized by compression of the third portion of the duodenum by the SMA as it passes over this portion of the duodenum. Duodenojejunostomy is usually considered to be the treatment of choice. We recently experienced the case of a very thin 19-year-old female with the diagnosis of SMA syndrome. We started nasogastric tube decompression and total parenteral nutrition, but that was ineffective; we then performed laparoscopic duodenojejunostomy. We herein report on this successful laparoscopic duodenojejunostomy procedure along with a review of the relevant literature.     

Mycotic aneurysm of internal carotid artery — A case report

Mycotic aneurysms are rare entities. Most of them occur in aorta or femoral artery. Mycotic aneurysm of extracranial carotid artery has been reported quite infrequently in the literature. Surgical intervention is mandatory. The ideal treatment is to excise the aneurysm and restore the circulation by interposition grafting by saphenous vein. However the limited access to extracranial internal carotid artery and the presence of infection at that site may not always allow the ideal management. Ligation of the aneurysm is a practical life-saving method in such cases. We are presenting our experience with one such patient who presented with a painful bleeding swelling in the throat and was successfully treated with ligation of internal carotid artery.     

介入治疗脾动脉-肠系膜上动脉干起源脾动脉瘤1例

患者女,49岁,体检发现脾动脉瘤9个月,查体及实验室检查未见异常。影像学检查：腹部CTA（图1A）示变异的脾动脉起源于脾动脉一肠系膜上动脉干,脾动脉起始部动脉瘤形成,约20mm×24mm。经肠系膜上动脉造影（图1B）证实诊断后行介入治疗。将2．7F微导管引入脾动脉瘤颈以及远端部位。经左肱动脉穿刺。置入8F动脉鞘．待导丝（加硬钢丝）进入肠系膜上动脉后,沿导丝释放覆膜支架（直径6mm。长40mm）,覆盖脾动脉一肠系膜上动脉干开口。