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Case Reports
. 2018 May 8:39:16-19.
doi: 10.1016/j.ejvssr.2018.04.002. eCollection 2018.

A Challenging Case of Fibromuscular Dysplasia in a Transgender Patient: Is There a Hormonal Link?

Ahmed Shalan  1 , Michael Hughes  1 , Marcus Nicholls  1 , Andrew Thompson  1
Affiliations
Case Reports

A Challenging Case of Fibromuscular Dysplasia in a Transgender Patient: Is There a Hormonal Link?

Ahmed Shalan et al. EJVES Short Rep. .

Abstract

Introduction: Fibromuscular dysplasia (FMD) and superior mesenteric artery (SMA) aneurysms are rare vascular conditions. An unusual combination of both diseases is reported.

Case report: A 54 year old woman presented with symptomatic SMA aneurysm. A diagnosis of FMD was made on the basis of computed tomography angiography (CTA). The patient had undergone gender reassignment surgery 10 years previously and continued to use both topical and oral hormonal therapy. The patient received open anatomical bypass through a retroperitoneal approach using great saphenous vein.

Conclusion: Superior mesenteric artery aneurysms are rare and a diagnosis of FMD should be considered as part of the diagnosis process. Anatomical bypass should be considered carefully in relation to a patient's fitness as well as anatomical suitability.

Keywords: Chronic mesenteric ischaemia; Fibromuscular dysplasia; Superior mesenteric artery; Visceral artery.

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Figures

Figure 1
Figure 1
(A) Computed tomography angiography reconstruction showing aberrant right hepatic and thrombosed superior mesenteric artery aneurysm. (B) Beaded appearance of both renal arteries. (C) Mid right internal carotid artery 6 mm aneurysm.
Figure 2
Figure 2
(A) Medial visceral rotation anterior to left kidney, vein graft anastomosis to the origin of the superior mesenteric artery. (B) Distal anastomosis through the infra-colic compartment.
Figure 3
Figure 3
Post-reconstruction computed tomography angiogram showing anatomical bypass graft.
See this image and copyright information in PMC

References

    1. Leadbetter W., Burkland C. Hypertension in unilateral renal disease. J Urol. 1938;39:611–626.
    1. Olin J., Sealove B. Diagnosis, management, and future developments of fibromuscular dysplasia. J Vasc Surg. 2011;53:826–836. e1. - PubMed
    1. Olin J., Pierce M. Contemporary management of fibromuscular dysplasia. Curr Opin Cardiol. 2008;23:527–536. - PubMed
    1. Jiang J., Ding X., Su Q., Zhang G., Wang Q., Jian W. Therapeutic management of superior mesenteric artery aneurysms. J Vasc Surg. 2011;53:1619–1624. - PubMed
    1. Becquemin J. Management of the diseases of mesenteric arteries and veins. Eur J Vasc Endovasc Surg. 2017;53:455–457. - PubMed

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