title: Revascularization of the celiac and superior mesenteric arteries after operative injury using both splenic artery and saphenous graft.
abstract: We report a case of iatrogenic resection of both the superior mesenteric artery (SMA) and celiac artery during left nephrectomy and adrenalectomy. A 47-year-old woman was diagnosed with a large adrenal tumor and underwent a laparoscopic left adrenalectomy that was converted to open adrenalectomy and nephrectomy as a result of a bulky tumor. Both the SMA and celiac artery were inadvertently cut at their origin because of adherence of the tumor to the aorta. Both arteries were revascularized by anastomosing the distal splenic artery to the aorta after performing splenectomy to revascularize the celiac circulation and using an autologous saphenous vein graft to revascularize the SMA. The patient had no postoperative complications. To our knowledge, this is the first description of use of the splenic artery for celiac revascularization.
authors.affiliation: Dept of Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: Samir
authors.initials: S
authors.lastname: Abu-Gazala
authors.forename: Avraham
authors.initials: A
authors.lastname: Schlager
authors.forename: Ram
authors.initials: R
authors.lastname: Elazary
authors.forename: Andrei
authors.initials: A
authors.lastname: Keidar
authors.forename: Liat
authors.initials: L
authors.lastname: Appelbaum
authors.forename: Avraham I
authors.initials: AI
authors.lastname: Rivkind
authors.forename: Abed
authors.initials: A
authors.lastname: Khalaileh
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Abu-Gazala
authors.forename: Hadar
authors.initials: H
authors.lastname: Merhav
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000601:surgery*; D000315:Adrenalectomy / Q000009:adverse effects*; D000714:Anastomosis, Surgical; D002445:Celiac Artery / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects*; D012501:Saphenous Vein / Q000637:transplantation*; D013157:Splenic Artery / Q000637:transplantation*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome