Congenital superior mesenteric artery aneurysm in a 6-week-old infant presenting with upper gastrointestinal bleeding

Area of Science:

• Pediatric surgery
• Vascular surgery
• Gastroenterology

Background:

• Visceral artery aneurysms (VAAs) are uncommon in pediatric populations, often linked to genetic conditions, trauma, or infections.
• While frequently asymptomatic, VAAs can lead to significant complications such as abdominal pain, nausea, vomiting, or life-threatening rupture.
• Rupture of VAAs may present as hemodynamic instability or gastrointestinal bleeding, requiring urgent intervention.

Observation:

• A rare case of a congenital idiopathic aneurysm of the superior mesenteric artery (SMA) was observed in a 6-week-old infant.
• The infant presented with significant gastrointestinal bleeding, indicating a critical complication of the SMA aneurysm.
• The case highlights the potential for rapid development of mesenteric collateral circulation in pediatric patients.

Findings:

• A stepwise surgical technique was employed to successfully exclude the superior mesenteric artery aneurysm and induce thrombosis.
• The surgical intervention effectively managed the gastrointestinal bleeding and stabilized the patient.
• Post-operative assessment confirmed the robustness of the mesenteric collateral circulation, crucial for maintaining visceral perfusion.

Implications:

• This case demonstrates a viable surgical strategy for managing pediatric visceral artery aneurysms, particularly SMA aneurysms.
• Highlights the importance of recognizing and promptly treating VAAs in infants to prevent catastrophic rupture.
• Emphasizes the adaptive capacity of mesenteric collateral circulation in children, which aids in surgical management and recovery.