Superior Mesenteric Artery Pseudoaneurysm Induced by Accidental Ingestion of a Foreign Body: Case Report.
Foreign body
Paediatric
Superior mesenteric artery
Superior mesenteric artery pseudoaneurysm
Journal
EJVES vascular forum
ISSN: 2666-688X
Titre abrégé: EJVES Vasc Forum
Pays: England
ID NLM: 101766732
Informations de publication
Date de publication:
2022
2022
Historique:
received:
25
05
2021
revised:
16
12
2021
accepted:
04
01
2022
entrez:
11
2
2022
pubmed:
12
2
2022
medline:
12
2
2022
Statut:
epublish
Résumé
Superior mesenteric artery (SMA) pseudoaneurysm is a very rare condition, typically associated with trauma, inflammation, and infection, and as a post-operative complication. If left untreated it can lead to serious consequences such as rupture and fatal haemorrhage. A 17 year old male presented to the emergency department with a history of intermittent progressive epigastric pain with no preceding significant symptoms of a possible cause. He was initially treated conservatively until the intensity of pain was so severe an abdominal computed tomography (CT) scan was justified. A pseudoaneurysm of the SMA was found. Full inflammatory and immunological workup was unremarkable. Repeat CT scan showed the SMA pseudoaneurysm was larger, mandating surgical intervention; the vascular surgeon suggested an exploratory laparotomy. Intra-operatively, unexpectedly, a wooden foreign body measuring 5.0 × 0.3 × 0.5 cm was seen once the aneurysm sac was opened. The pseudoaneurysm was repaired and the abdomen closed after ascertaining that all other organs were intact. The patient had a simple recovery with no complications and was discharged home. The follow up CT scans were unremarkable. Pseudoaneurysm of the SMA in the paediatric age group is an extremely rare and life threatening phenomenon. The clinical presentation may be subtle, leading to delayed diagnosis. Early surgical intervention may be lifesaving and prevent further complications.
Sections du résumé
BACKGROUND
BACKGROUND
Superior mesenteric artery (SMA) pseudoaneurysm is a very rare condition, typically associated with trauma, inflammation, and infection, and as a post-operative complication. If left untreated it can lead to serious consequences such as rupture and fatal haemorrhage.
REPORT
METHODS
A 17 year old male presented to the emergency department with a history of intermittent progressive epigastric pain with no preceding significant symptoms of a possible cause. He was initially treated conservatively until the intensity of pain was so severe an abdominal computed tomography (CT) scan was justified. A pseudoaneurysm of the SMA was found. Full inflammatory and immunological workup was unremarkable. Repeat CT scan showed the SMA pseudoaneurysm was larger, mandating surgical intervention; the vascular surgeon suggested an exploratory laparotomy. Intra-operatively, unexpectedly, a wooden foreign body measuring 5.0 × 0.3 × 0.5 cm was seen once the aneurysm sac was opened. The pseudoaneurysm was repaired and the abdomen closed after ascertaining that all other organs were intact. The patient had a simple recovery with no complications and was discharged home. The follow up CT scans were unremarkable.
CONCLUSION
CONCLUSIONS
Pseudoaneurysm of the SMA in the paediatric age group is an extremely rare and life threatening phenomenon. The clinical presentation may be subtle, leading to delayed diagnosis. Early surgical intervention may be lifesaving and prevent further complications.
Identifiants
pubmed: 35146470
doi: 10.1016/j.ejvsvf.2022.01.002
pii: S2666-688X(22)00002-8
pmc: PMC8819108
doi:
Types de publication
Case Reports
Langues
eng
Pagination
36-39Informations de copyright
© 2022 The Authors.
Références
Eur J Vasc Endovasc Surg. 2017 Apr;53(4):460-510
pubmed: 28359440
Ann Vasc Surg. 2018 Jul;50:299.e5-299.e7
pubmed: 29518518
J Vasc Surg. 2002 Aug;36(2):234-7; discussion 237
pubmed: 12170202
Ann Vasc Surg. 2013 Jul;27(5):672.e7-11
pubmed: 23809936
Proc (Bayl Univ Med Cent). 2015 Jul;28(3):355-7
pubmed: 26130888
Am Surg. 2012 Aug;78(8):E358-60
pubmed: 22856476
Ann Vasc Surg. 2014 Aug;28(6):1563.e1-5
pubmed: 24704049
Radiographics. 2013 May;33(3):E71-96
pubmed: 23674782
Vasc Endovascular Surg. 2007 Dec-2008 Jan;41(6):568-71
pubmed: 18166643
J Laryngol Otol. 1978 May;92(5):429-34
pubmed: 650073