Endovascular Treatment of Ileocolic Pseudoaneurysm After a Laparoscopic-Assisted Bowel Resection for Crohn Disease

Abstract

Since the introduction of laparoscopic-assisted ileocolic resection for Crohn disease more than 15 years ago, it has become established as a challenging but feasible and safe procedure. A crucial step in the operation is the division of the thick and chronically inflamed mesentery, which in many cases is performed extracorporeally. We report a case of a 32-year-old man with a 14-year history of Crohn ileitis who underwent elective laparoscopic-assisted ileocolic resection. His procedure and the postoperative course were uneventful. A computed tomography scan 2 weeks later revealed a 3-cm-diameter asymptomatic mesenteric pseudoaneurysm, which was successfully treated by transcatheter coil embolization. Pseudoaneurysm of mesenteric arteries has not been documented before in relation to bowel resection by conventional or minimally invasive approaches. It is likely that the thick vascular mesentery of this patient with Crohn disease was a contributing factor to this complication.