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Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Massive upper gastrointestinal bleeding due to a ruptured superior mesenteric artery aneurysm duodenum fistula
1Division of Vascular Surgery, West China Hospital, Sichuan, China. jichunzhao@hotmail.com
Abstract:
This case report describes sudden massive upper gastrointestinal bleeding due to a ruptured superior mesenteric artery aneurysm-duodenal fistula following mitral and aortic valvular replacement surgery due to infectious endocarditis. The superior mesenteric artery false aneurysm was diagnosed by computed tomography scanning. The intraoperative findings included a rupture at the trunk of superior mesenteric artery (SMA) and a perforation on the anterior wall of the third portion of the duodenum. The patient was treated by emergency surgery, which consisted of an interposition repair of the SMA with a saphenous vein graft for the superior mesenteric artery and a duodenojejunal Roux-en-Y anastomosis for the perforation of the duodenum. At 30-months follow-up, the patient is alive and well with no abdominal pain and eating a regular diet.
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