The Endovascular Treatment of a Ruptured Aneurysm of the Middle Colic Artery Combined With an Isolated Dissection of Superior Mesenteric Artery

Abstract

Background:

Ruptured aneurysm of the middle colic artery is very rare. Its concomitance with isolated dissection of the superior mesenteric artery (SMAD) has not yet been reported in the literature.

Case report:

A previously well 56-year-old man was referred to our hospital with acute-onset pain throughout the entire abdomen. A ruptured aneurysm of the middle colic artery and isolated SMAD were revealed using a computed tomography (CT) scan. Coil embolization was successfully performed for a ruptured aneurysm of the middle colic artery. During the immediate postprocedural period, the patient had ischemic colitis, but he recovered in a few days with conservative treatment. Close observation was elected to address the SMAD because the condition was not thought to be responsible for any symptoms. The CT scan followed after 2 years showed no change in SMAD.

Conclusions:

We successfully performed endovascular treatment for a ruptured aneurysm of the middle colic artery. For the incidentally detected SMAD, close observational management was chosen.

Keywords

middle colic artery aneurysm rupture superior mesenteric artery dissection endovascular therapy coil embolization

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References

Sarcina

Bellosta

Magnali

Luzzani

. Aneurysm of the middle colic artery-case report and literature review. Eur J Vasc Endovasc. 2000;20(2):198–200.

Rockman

Maldonado

. Splanchnic artery aneurysms. In: JL

Cronenwett

Johnston

, editors. Rutherford’s Vascular Surgery. 7th ed. Philadelphia, PA: Saunders Elsevier; 2010:2150–2154.

Takagi

Ashizawa

Eishi

. Segmental mediolytic arteriopathy involving celiac to splenic and left renal arteries. Intern Med. 2003;42(9):818–823.

Yamada

Ohno

Itagaki

Takaba

Matsuyama

. Coexistence of cystic medial necrosis and segmental arterial mediolysis in a patient with aneurysms of the abdominal aorta and the iliac artery. J Vasc Surg. 2004;39(1):246–249.

Naito

Toyota

Ito

. Embolization of a ruptured middle colic artery aneurysm. Cardiovasc Intervent Radiol. 1995;18(1):56–58.

Cho

Lee

. Treatment guidelines for isolated dissection of the superior mesenteric artery based on follow-up ct findings. Eur J Vasc Endovasc Surg. 2011;41(6):780–785.

Toyonaga

Nagaoka

Ouchida

. Case of a bleeding pseudoaneurysm of the middle colic artery complicating acute pancreatitis. Hepatogastroenterology. 2002;49(46):1141–1143.

Tessier

Abbas

Fowl

. Management of rare mesenteric arterial branch aneurysms. Ann Vasc Surg. 2002;16(5):586–590.

Tulsyan

Kashyap

Greenberg

. The endovascular management of visceral artery aneurysms and pseudoaneurysm. J Vasc Surg. 2007;45(2):276–283.

10.

Hirokawa

Sawai

Yamada

. Middle-colic artery aneurysm associated with segmental arterial mediolysis, successfully managed by transcatheter arterial embolization: report of a case. Surg Today. 2009;39(2):144–147.

11.

Naru

Yoshihiro

Masaki

. Ruptured left colic arterial aneurysm treated by transcatheter arterial embolization alone and without a subsequent laparotomy: report of a case. Surg Today. 2011;41(5):707–712.

12.

Kasirajan

Greenberg

Clair

Ouriel

. Endovascular management of visceral artery aneurysm. J Endovasc Ther. 2001;8(2):150–155.

13.

Park

Kim

. Natural history of spontaneous isolated superior mesenteric artery dissection derived from follow-up after conservative treatment. J Vasc Surg. 2011;54(6):1727–1733.