title: Ruptured and unruptured mycotic superior mesenteric artery aneurysms.
abstract: Aneurysms of the superior mesenteric artery (SMA) and branches thereof are uncommon but have a high rate of rupture and mortality relative to other visceral artery aneurysms. Historically, the predominant etiology has been infectious; with a renewed rise in intravenous drug abuse rates in the last decade, we hypothesize a resurgence in septic embolic complications may occur in the coming years. Here, we describe the presentation and management of 2 cases of intravenous drug users presenting with infectious endocarditis and SMA main trunk and branch aneurysms, one of which was ruptured. In addition, we review the literature on these rare clinical entities.
authors.affiliation: Department of Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston, MA. Electronic address: gsharma1@partners.org.
authors.forename: Gaurav
authors.initials: G
authors.lastname: Sharma
authors.affiliation: Department of Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
authors.forename: Marcus E
authors.initials: ME
authors.lastname: Semel
authors.affiliation: Department of Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
authors.forename: Edward A
authors.initials: EA
authors.lastname: McGillicuddy
authors.affiliation: Department of Surgery, Northwestern Memorial Hospital, Chicago, IL.
authors.forename: Karen J
authors.initials: KJ
authors.lastname: Ho
authors.affiliation: Department of Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Menard
authors.affiliation: Department of Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Gates
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis / Q000382:microbiology; D000328:Adult; D000785:Aneurysm, Infected / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D017542:Aneurysm, Ruptured / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery; D008297:Male; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000601:surgery; D013290:Streptococcal Infections / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D015819:Substance Abuse, Intravenous / Q000150:complications*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures; D055815:Young Adult