title: Mini-Laparotomy for Superior Mesenteric Artery Aneurysm Due to Takayasu's Arteritis.
abstract: Superior mesenteric artery aneurysm (SMAA) is reported to be the third-most common type of visceral aneurysm (VA), accounting for 5% of all VAs. The etiology of SMAA is commonly thought to be infection, and it usually exists in the proximal part of the superior mesenteric artery, which is suitable for endovascular treatment. We herein report an extremely rare case of the distal part of SMAA caused by Takayasu's arteritis (TA), which was successfully resected using a mini-laparotomy method without impairing the intestinal blood supply. A 51-year-old woman was admitted to our hospital with sustained fever and lower back pain. Physical examination showed that she had a discrepancies in blood pressure between both arms. Contrast-enhanced whole-body computed tomography showed stenosis of the thoracic aorta and an aneurysm located in the distal part of the superior mesenteric artery. The diameter of the aneurysm was 4.5 cm. The aneurysm was resected via 4-cm mini-laparotomy, and the vascularity of the intestine was successfully preserved. The postoperative course was uneventful, and the patient was diagnosed as having TA based on both clinical and pathologic findings. Additional corticosteroid therapy was started to treat the arteritis, and at 3-month follow-up she was without critical incidents. Mini-laparotomy is a safe and less-invasive approach to treat SMAA, especially when the lesion is located in the distal part of the artery.
authors: Department of Gastroenterological Surgery, Dokkyo Medical University, Tochigi, Japan.
authors: Takatsugu
authors: T
authors: Matsumoto
authors: Mitsuru
authors: M
authors: Ishizuka
authors: Yukihiro
authors: Y
authors: Iso
authors: Junji
authors: J
authors: Kita
authors: Keiichi
authors: K
authors: Kubota
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000783:Aneurysm / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D003287:Contrast Media; D005260:Female; D006801:Humans; D007813:Laparotomy / Q000379:methods*; D017538:Mesenteric Artery, Superior; D008875:Middle Aged; D013625:Takayasu Arteritis / Q000150:complications* / Q000188:drug therapy; D014057:Tomography, X-Ray Computed
chemical_list: D000305:Adrenal Cortex Hormones; D003287:Contrast Media
keywords: Mini-laparotomy; Superior mesenteric artery aneurysm; Takayasu's arteritis