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Updated: Apr 27, 2026

Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
[Endocarditis complicated by an aneurysm of the superior mesenteric artery]
E G A Hatim1, M-A Hachimi1, H Madani1
1Service d'anesthésie-réanimation chirurgie cardiaque, hôpital militaire Mohammed V Hay Riad, 11000 Rabat, Maroc.
Abstract:
Infective endocarditis (IE) is a rare, polymorphic disease in children. Mycotic aneurysm is a rare condition that complicates about 2.5 to 10% of cases of endocarditis. It is responsible for significant morbidity and mortality [1,2]. Mycotic aneurysms are often asymptomatic, physical examination is poor, but the diagnosis should be considered with the triad including fever, abdominal pain, and abdominal mass beating. Abdominal ultrasound and computed tomography are the most useful for the identification of the aneurysmal mass. However, angiography is an interesting addition to confirm the diagnosis and implement a treatment procedure [3]. The treatment of SMA aneurysms is largely surgical. IE treatment is based on antibiotic therapy combined with surgical repair. We report the case of a 15-year-old patient, first operated for an SMA aneurysm complicating the course of IE, who secondarily underwent mitral valve repair. We review the epidemiology, diagnosis, and care principles of mycotic aneurysms of the SMA.
Insights
Infective endocarditis can lead to rare but serious mycotic aneurysms, particularly in children. Prompt diagnosis and surgical intervention are crucial for managing these life-threatening vascular complications.
Area of Science:
- Pediatric Cardiology
- Vascular Surgery
- Infectious Diseases
Background:
- Infective endocarditis (IE) is a rare pediatric disease.
- Mycotic aneurysms complicate 2.5-10% of IE cases, causing significant morbidity and mortality.
- Early diagnosis and management are critical.
Observation:
- Mycotic aneurysms are often asymptomatic, with diagnosis suggested by fever, abdominal pain, and a pulsatile abdominal mass.
- Abdominal ultrasound and CT scans are key diagnostic tools.
- Angiography aids in diagnosis confirmation and treatment planning.
Findings:
- The case involved a 15-year-old treated surgically for a superior mesenteric artery (SMA) aneurysm complicating IE.
- The patient later underwent mitral valve repair.
- SMA aneurysm treatment is primarily surgical, alongside antibiotic therapy for IE.
Implications:
- This case highlights the importance of considering mycotic aneurysms in children with IE.
- Integrated surgical and antibiotic approaches are vital for optimal outcomes.
- Further research into the epidemiology and management of pediatric mycotic aneurysms is warranted.
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Aneurysm II: Clinical Manifestations and Diagnostic Studies
Aneurysm I: Introduction
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Myocarditis I: Introduction
Rheumatic Heart Disease I: Introduction

