scholarly journals Visceral Mycotic Aneurysm: Superior Mesenteric Artery Aneurysm Caused by K. pneumoniae

2021 ◽  
pp. 1-4
Author(s):  
Reham Almasoud ◽  
Alaaeddin Nwilati ◽  
Saeb Bayazid ◽  
Mamoun Shafaamri
Keyword(s):  
Infectious Disease ◽  
Antibiotic Therapy ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Mycotic Aneurysm ◽  
Artery Aneurysm ◽  
Management Plan ◽  
Resected Tissue ◽  
Infectious Disease Specialists

We herein report a rare case of mycotic aneurysm of the superior mesenteric artery caused by <i>Klebsiella pneumoniae</i>. A 66-year-old man, a known case of hypertension and aorto-oesophageal fistula with stented aorta in 2010 and 2018, presented to the emergency department multiple times over 2 months with severe postprandial abdominal pain associated with vomiting and fever. On his last presentation, the obtained blood cultures grew ESBL positive <i>K. pneumoniae</i> and a repeated computed tomography (CT) showed a growing aneurysm at the origin of the ileocecal branch of the superior mesenteric artery measuring 17 × 10 mm (the aneurysm was 8 × 7.5 mm in the CT angiography on the previous admission). Extensive workup did not reveal the underlying cause of the mycotic aneurysm, thus we believe the cause to be the infected aortic stent, leading to bacteraemia and vegetations to the mesenteric artery causing the aneurysm. The management plan was placed by a multidisciplinary team consisting of vascular surgeons and infectious disease specialists along with review from a dietician to evaluate the patient’s nutritional status. The patient was started on total parenteral nutrition due to his postprandial pain and on antibiotic therapy according to the infectious disease team’s recommendation. He underwent surgical resection of the mycotic aneurysm, which showed a thrombosed aneurysm in the jejunoileal mesenteric area. The histopathology of the resected tissue demonstrated inflammatory aneurysm of the mesenteric artery. Following the surgery, the patient continued his antibiotic therapy and was discharged on the 13th post-operative day with follow-up appointments in the vascular surgery and infectious disease clinic.

Mycotic Superior Mesenteric Artery Aneurysm: Case Report and Literature Review

2018 ◽  
Vol 26 (2) ◽  
pp. 260-264 ◽  
Author(s):  
Xuedong Xu ◽  
Alicia L. Eubanks ◽  
Alan Wladis ◽  
Paula Veldhuis ◽  
Steve Eubanks
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Mycotic Aneurysm ◽  
Artery Aneurysm ◽  
The Third ◽  
Splanchnic Artery Aneurysm ◽  
Splanchnic Artery

Superior mesenteric artery (SMA) aneurysm is the third most common splanchnic artery aneurysm. A 73-year-old woman presented with a minimally symptomatic SMA aneurysm, which was resected by laparoscopic surgical technique. The patient recovered quickly and remained well after 8 months of follow-up. This case report and literature review presents a rare mycotic aneurysm that developed in the SMA. Laparoscopic surgery can be a useful technique for the treatment of mycotic SMA aneurysms.

Experience of managing superior mesenteric artery aneurysm and its midterm follow-up results with 18 cases

Vascular ◽  
2020 ◽  
pp. 170853812096288
Author(s):  
Lunchang Wang ◽  
Chang Shu ◽  
Quanming Li ◽  
Xiaohua Jiang ◽  
Xin Li ◽  
...  
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Clinical Decision Making ◽  
Demographic Data ◽  
Clinical Manifestations ◽  
Artery Aneurysm ◽  
Aneurysm Rupture ◽  
Covered Stents ◽  
True Aneurysm

Objectives To characterize the clinical features, treatment, and prognosis of superior mesenteric artery aneurysms and provide evidence for clinical decision-making. Methods We retrospectively reviewed the diagnosis and treatment of 18 cases of superior mesenteric artery aneurysm admitted to our center from 2003 to 2020, including demographic data, risk factors, clinical manifestations, diagnosis, treatment strategies, and follow-up results. Results The average age of the patients was 49.1 years, and males accounted 83.3%. The development of the disease was associated with infection, hypertension, pancreatitis, and trauma, but no significant associations with atherosclerosis were noted by our results. Nine patients were diagnosed with true aneurysm, seven patients with pseudoaneurysm, and two patients with dissecting aneurysm. Rupture of aneurysm occurred in three patients (16.7%), and one of them died before surgery. The surgery success rate was 94.1%, and open surgery was performed on nine patients, endovascular surgery on three patients, and conservative treatment on three patients. The follow-up rate was 77.8% (14/18), and the average follow-up time was 48.2 months. The mortality and reintervention rate during follow-up was 0. The two-year patency rate of artificial vessels and covered stents was 50%. Conclusion The clinical manifestations and features of superior mesenteric artery aneurysms vary between patients. Careful evaluation of vascular anatomy and personalized treatment strategy are critical in the management of superior mesenteric artery aneurysms. Midterm follow-up results of superior mesenteric artery aneurysms are satisfactory.

Antibiotic Therapy Did Not Prevent the Rupture of Mycotic Aneurysm of the Superior Mesenteric Artery

2015 ◽  
Vol 18 (3) ◽  
pp. 088
Author(s):  
Ye-tao Li ◽  
Xiao-bin Liu ◽  
Tao Wang
Keyword(s):  
Abdominal Pain ◽  
Infective Endocarditis ◽  
Aortic Valve ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Mycotic Aneurysm ◽  
Acute Abdominal Pain ◽  
Rare Complication ◽  
Emergency Operation ◽  
History Of

<p class="p1"><span class="s1">Mycotic aneurysm of the superior mesenteric artery (SMA) is a rare complication of infective endocarditis. We report a case with infective endocarditis involving the aortic valve complicated by multiple septic embolisms. The patient was treated with antibiotics for 6 weeks. During preparation for surgical treatment, the patient developed acute abdominal pain and was diagnosed with a ruptured SMA aneurysm, which was successfully treated with an emergency operation of aneurysm ligation. The aortic valve was replaced 17 days later and the patient recovered uneventfully. In conclusion, we present a rare case with infective endocarditis (IE) complicated by SMA aneurysm. Antibiotic treatment did not prevent the rupture of SMA aneurysm. Abdominal pain in a patient with a recent history of IE should be excluded with ruptured aneurysm.</span></p>

Anomalous splenic artery aneurysm

Vascular ◽  
2013 ◽  
Vol 21 (2) ◽  
pp. 105-108 ◽  
Author(s):  
Sydney S N Wong ◽  
T F Lindsay ◽  
G Roche-Nagle
Keyword(s):  
Superior Mesenteric Artery ◽  
Surgical Resection ◽  
Surgical Management ◽  
Mesenteric Artery ◽  
Splenic Artery ◽  
Artery Aneurysm ◽  
Anomalous Origin ◽  
Splenic Artery Aneurysm ◽  
Visceral Aneurysm ◽  
Preservation Of The Spleen

Aneurysms of the splenic artery are the most common visceral aneurysm. A splenomesenteric trunk, which involves the splenic artery arising from the superior mesenteric artery (SMA), is rare and occurs in less than 1% of patients. Thus splenic artery aneurysms (SAAs) with an anomalous origin from the SMA are quite rare. We report our experience with the surgical management of a 2.6-cm aneurysm involving a splenic artery arising from the SMA in a 40-year-old woman. This was treated with surgical resection with preservation of the spleen. A discussion about SAAs and the management of aneurysms arising from a splenomesenteric trunk follows.

scholarly journals Clinical presentation, management, follow-up, and outcomes of isolated celiac and superior mesenteric artery dissections

2017 ◽  
Vol 65 (1) ◽  
pp. 91-98 ◽  
Author(s):  
Sara L. Zettervall ◽  
Eleonora G. Karthaus ◽  
Peter A. Soden ◽  
Dominique B. Buck ◽  
Klaas H.J. Ultee ◽  
...  
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Clinical Presentation

Endovascular Treatment of an Acute Superior Mesenteric Artery Occlusion following Failed Surgical Embolectomy

2003 ◽  
Vol 10 (2) ◽  
pp. 386-391 ◽  
Author(s):  
Saim Yilmaz ◽  
Alihan Gürkan ◽  
Okan Erdoğan ◽  
Timur Sindel ◽  
Kağan Çeken ◽  
...  
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Artery Occlusion ◽  
Distal Embolization ◽  
Primary Stenting ◽  
History Of ◽  
Surgical Embolectomy ◽  
Failed Surgery ◽  
Symptom Recurrence

Purpose: To present the successful primary stenting of a superior mesenteric artery (SMA) occlusion following failed surgical embolectomy. Case Report: A 65-year-old woman with a history of atrial fibrillation underwent surgical embolectomy of an acute embolic occlusion of the superior mesenteric artery (SMA). The following day, symptom recurrence suggested reocclusion, which was confirmed with emergent arteriography. Two balloon-expandable stents were deployed primarily, which ameliorated the patient's symptoms. Follow-up angiography at 3 months showed continued SMA patency, with no evidence of distal embolization or restenosis. The patient remains asymptomatic at 9 months after the stent procedure. Conclusions: Although more experience is required, primary stenting may be a valuable alternative in the treatment of acute SMA occlusions, in particular, for reocclusions after failed surgery.

Sign in / Sign up

Export Citation Format

Share Document