Jejunal Artery Aneurysm Exclusion With Immediate Vascular Reconstruction: A Case Report

A 44 year-old previously healthy woman presented a persistent epigastric pain. Computed tomography revealed a saccular aneurysm with a diameter of 25x20 mm in the first jejunal artery and also a stenosis in the celiac trunk associated with median arcuate ligament syndrome, turning the hepatic perfusion dependent of the gastroduodenal artery flow. Through a midline laparotomy, celiac axis was exposed, and median arcuate ligament released for median arcuate ligament syndrome treatment. A tangential resection of the aneurysm was done, preserving the flow in the jejunal artery. Arterial closure was achieved through an anastomosis between the jejunal artery and the bevelled pancreatoduodenal artery. One of the duodenal branches was also re-implanted in the jejunal artery. The patient's post-operative course was uneventful. At 1 year after the surgery, patient is asymptomatic and with patency of the reconstructed arteries.