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Multimodality Diagnosis of Mesenteric Ischemia
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Mesenteric mycotic pseudoaneurysm: a hidden catastrophe.

Sachin S Saboo1, Bharti Khurana, Yu-Hsiang Juan

  • 1Emergency Radiology Program, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA, saboo_100@yahoo.com.

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A rare mesenteric mycotic pseudoaneurysm, often missed on CT scans, was identified in a young man with a history of intravenous drug abuse. This case highlights the importance of considering this diagnosis in similar patient populations.

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Area of Science:

  • Radiology
  • Vascular Surgery
  • Infectious Diseases

Background:

  • Mycotic pseudoaneurysms are rare vascular complications, particularly in the mesentery.
  • Intravenous drug abuse is a significant risk factor for infectious vascular complications.

Observation:

  • A 23-year-old male with a history of intravenous drug abuse presented with symptoms requiring emergency radiology evaluation.
  • Routine computed tomography (CT) imaging initially overlooked the presence of a mesenteric pseudoaneurysm.

Findings:

  • The study details the radiology-surgical correlation for a mesenteric mycotic pseudoaneurysm.
  • The pseudoaneurysm was challenging to detect on standard CT protocols, emphasizing potential diagnostic pitfalls.

Implications:

  • This case underscores the necessity of high suspicion for mycotic pseudoaneurysms in patients with risk factors like intravenous drug abuse.
  • Enhanced imaging or tailored CT protocols may be required for early detection.
  • Accurate and timely diagnosis is crucial for effective surgical management and preventing catastrophic complications.