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Related Experiment Videos

Gastrointestinal bleeding and mycotic superior mesenteric aneurysm

C B Wright, W J Schoepfle, S B Kurtock

    Surgery
    |July 1, 1982
    PubMed
    Summary

    This case report details managing a rare mycotic superior mesenteric artery aneurysm after aortic valve replacement. Surgical repair with a saphenous vein graft successfully restored blood flow, offering a potential treatment for this critical condition.

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    Area of Science:

    • Vascular Surgery
    • Infectious Diseases
    • Gastroenterology

    Background:

    • Mycotic aneurysms, particularly of the superior mesenteric artery (SMA), are rare and pose significant diagnostic and management challenges.
    • Delayed diagnosis can result from non-specific symptoms like gastrointestinal bleeding, especially in patients with comorbidities such as those requiring anticoagulation or with a history of endocarditis.

    Observation:

    • A patient presented with delayed-onset mycotic SMA aneurysm two years post-aortic valve replacement for endocarditis.
    • Initial symptoms included chronic ulcer history, anticoagulation, episodic GI bleeding, negative gastrointestinal series, and gastritis, which obscured the diagnosis.
    • Massive hemorrhage ultimately led to diagnosis via angiography and surgical confirmation.

    Findings:

    • Surgical management involved debridement and extirpation of the aneurysm.

    Related Experiment Videos

  • Doppler assessment revealed inadequate collateral mesenteric blood flow.
  • Restoration of mesenteric blood flow was achieved using a saphenous vein bypass graft.

    • Implications:

    • This case highlights the importance of considering mycotic aneurysms in patients with relevant risk factors and persistent gastrointestinal symptoms.
    • Successful reconstruction using a saphenous vein graft for a mycotic SMA aneurysm is described, adding to the limited literature on surgical management.
    • The findings suggest that this bypass technique is a viable option for restoring mesenteric blood flow in complex mycotic aneurysm cases.