title: A 6.5-cm pseudoaneurysm of the superior mesenteric artery managed by primary surgical repair.
abstract: Superior mesenteric artery (SMA) aneurysms are rare but associated with significant mortality (25-40%) when complicated by rupture or thrombosis. Symptomatic SMA aneurysms, asymptomatic aneurysms of ≥2 cm size and pseudoaneurysms need intervention. We report a case of a 6.5-cm symptomatic SMA aneurysm managed by open surgical repair. At intraoperative exploration, the aneurysm was recognized to be a pseudoaneurysm with a narrow neck (1 mm defect in the native vessel) and was dealt by primary repair. Clinical presentation, the role of radiological investigations and management are discussed. Detailed preoperative assessment of the anatomical characters is essential in planning the intervention for SMA aneurysms. The required information can be obtained by selective interventional angiogram or computed tomographic angiogram with three-dimensional reconstruction. Multi-institutional prospective databases might provide better evidence regarding the timing of intervention, treatment modality, postinterventional follow-up and surveillance of patients with mesenteric aneurysms.
authors.affiliation: Department of Vascular Surgery, Level 4, Belfast City Hospital, Belfast, UK. dasari@yahoo.com
authors.forename: Bobby V M
authors.initials: BV
authors.lastname: Dasari
authors.forename: Michael
authors.initials: M
authors.lastname: Mullan
authors.forename: Louis
authors.initials: L
authors.lastname: Lau
authors.forename: William
authors.initials: W
authors.lastname: Loan
authors.forename: Bernard
authors.initials: B
authors.lastname: Lee
mesh_terms: D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D013536:Suture Techniques; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures