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. 2010 Mar 8:5:7.
doi: 10.1186/1749-7922-5-7.

Endovascular treatment of a Superior Mesenteric Artery Syndrome variant secondary to traumatic pseudoaneurysm

Affiliations

Endovascular treatment of a Superior Mesenteric Artery Syndrome variant secondary to traumatic pseudoaneurysm

Iain Au-Yong et al. World J Emerg Surg. .

Abstract

Pseudoaneurysms related to the superior mesenteric artery (SMA) are a recognised complication of trauma to the vessel, and successful treatment with stenting has been previously described. We report the case of a patient who presented with obstruction of the fourth part of the duodenum secondary to a traumatic pseudoaneurysm, a hitherto unreported variant of superior mesenteric artery syndrome. Exclusion of the pseudoaneurysm and relief of the duodenal obstruction were simultaneously achieved by placement of a covered stent.

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Figures

Figure 1
Figure 1
Axial CT image with oral contrast demonstrating a small pseudoaneurysm (arrow) to the right of the SMA.
Figure 2
Figure 2
Barium small bowel meal demonstrates dilatation of the first to third parts of the duodenum and a rounded filling defect at the level of the fourth part (see arrow).
Figure 3
Figure 3
Axial CT images demonstrating the SMA pseudoaneurysm compressing the fourth part of the duodenum (arrow).
Figure 4
Figure 4
3-dimensional reconstructions of the CT better demonstrating the anatomical relationships and demonstrating communication between the connection between the SMA and the aneurysm sac (arrow).
Figure 5
Figure 5
Angiographic images from which the size of the defect into the pseudoaneurysm can be appreciated.
Figure 6
Figure 6
Angiographic image demonstrating appearances post-stent placement.
Figure 7
Figure 7
3-dimensional reconstruction demonstrating exclusion of the aneurysm following placement of the stent within the SMA.

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