RESUMO
Superior mesenteric artery (SMA) aneurysms are rare and often fatal. A 72-year-old man had previously been admitted to the emergency room with epigastric pain and heart murmur. The echocardiographic diagnosis was vegetation on the aortic and mitral valves, with moderate regurgitation from both valves due to infective endocarditis. No aneurysm was detected on abdominal computed tomography, and emergency double-valve replacement was performed. On postoperative day 25, the patient experienced abrupt abdominal pain, and computed tomography revealed a mycotic SMA aneurysm. Open surgical repair of the SMA aneurysm was performed using the femoral vein, and the patient's postoperative course was uneventful.
Assuntos
Idoso , Humanos , Dor Abdominal , Aneurisma , Diagnóstico , Ecocardiografia , Emergências , Serviço Hospitalar de Emergência , Endocardite , Veia Femoral , Sopros Cardíacos , Artéria Mesentérica Superior , Valva Mitral , EsternotomiaRESUMO
We report the findings of a patient with an asymptomatic Arc of Buhler (AOB) aneurysm, which was successfully treated by transcatheter coil embolization. An abdominal CT and angiography revealed an intact pancreaticoduodenal artery arcade (PDAA) and an anomalous communication between the SMA and celiac axis, termed an AOB. An aneurysm was observed at the origin of the AOB and treated with a transcatheter embolization using coils. A follow-up CT imaging confirmed the total occlusion of the aneurysm with a patent PDAA. The successful results of this treatment suggest that the endovascular therapy of an AOB aneurysm with a celiac axis occlusion and an intact PDAA is feasible and safe.
Assuntos
Adulto , Humanos , Masculino , Aneurisma/diagnóstico por imagem , Angiografia , Artéria Celíaca/anormalidades , Embolização Terapêutica , Artéria Mesentérica Superior/anormalidades , Tomografia Computadorizada por Raios XRESUMO
Mycotic aneurysm of mesenteric artery is an uncommon complication of infective endocarditis. Early diagnosis is important and surgical intervention is often needed for effective treatment of mycotic aneurysm of mesenteric artery because of the high incidence of aneurysmal rupture. We experienced a case of infective endocarditis complicated with mycotic aneurysm of the superior mesenteric artery in a 54-year old man, who was admitted because of pain on the right lower quadrant of abdomen. Echocardiography showed mitral regurgit-ation and vegetations on the mitral valve and viridans streptococcus was identified from blood cultures. He was successfully treated with ceftriaxone and gentamicin for the initial 2 weeks, then ceftriaxone alone for two weeks more without surgical intervention. To our knowledge, this is the first case of infective endocarditis complicated with superior mesenteric artery aneurysm in Korea.
Assuntos
Humanos , Pessoa de Meia-Idade , Abdome , Aneurisma , Aneurisma Infectado , Ceftriaxona , Diagnóstico Precoce , Ecocardiografia , Endocardite , Gentamicinas , Incidência , Coreia (Geográfico) , Artérias Mesentéricas , Artéria Mesentérica Superior , Valva Mitral , Ruptura , StreptococcusRESUMO
Superior mesenteric artery aneurysm is very rare complication of Marfan syndrome, especially in children. A 11 years old male patient was admitted to the hospital because of fluctuating high fever and diagnosed as infective endocarditis and Marfan syndrome. During antibiotics therapy, fever was slowly decreased but abdominal pain was developed and pulsatile abdominal mass was palpable in the midline of the abdomen. And the diagnosis was made as superior mesenteric artery aneurysm by ultrasonogaphy and abdominal aortogram. Resection of aneurysm was performed successfully. A brief review of the related literatures was made.
Assuntos
Criança , Humanos , Masculino , Abdome , Dor Abdominal , Aneurisma , Antibacterianos , Diagnóstico , Endocardite , Febre , Hipertermia Induzida , Síndrome de Marfan , Artéria Mesentérica SuperiorRESUMO
Superior mesenteric artery aneurysm is very rare complication of Marfan syndrome, especially in children. A 11 years old male patient was admitted to the hospital because of fluctuating high fever and diagnosed as infective endocarditis and Marfan syndrome. During antibiotics therapy, fever was slowly decreased but abdominal pain was developed and pulsatile abdominal mass was palpable in the midline of the abdomen. And the diagnosis was made as superior mesenteric artery aneurysm by ultrasonogaphy and abdominal aortogram. Resection of aneurysm was performed successfully. A brief review of the related literatures was made.
Assuntos
Criança , Humanos , Masculino , Abdome , Dor Abdominal , Aneurisma , Antibacterianos , Diagnóstico , Endocardite , Febre , Hipertermia Induzida , Síndrome de Marfan , Artéria Mesentérica SuperiorRESUMO
Aneurysm of the superior mesenteric artery(SMA) are rare, comprising between 5 and 8% of all visceral aneurysm. Recently visceral artery aneurysms have been detected incidently on routine CT and ultrasound(US) studies. Early diagnosis is critical in minimizing the resultant morbidity and mortality. With the progress in angiography and vascular surgery techniques, the use of surgery in dealing with this condition has become more frequent. A case report of large SMA aneurysm and review of the articles are presented.
Assuntos
Aneurisma , Angiografia , Artérias , Diagnóstico Precoce , Artéria Mesentérica Superior , MortalidadeRESUMO
Two cases of superior mesenteric artery (SMA) aneurysm were reported; one with atherosclerosis and the other was mycotic in origin. Preoperative investigations included plain radiography, ultrasonography, computed tomography with contrast injection, angiography and nuclearscanning. SMA aneurysm was then diagnosed and the patient underwent operation. Results of the operations were satisfactory. It is suggested that early and correct diagnosis is critical in minimizing morbidity and mortality in the patients with SMA aneurysm.