感染性心内膜炎を合併した上腸間膜動脈瘤に対する外科的治療の成功：真菌性動脈瘤の管理

Mycotic aneurysms of the superior mesenteric artery (SMA) are rare (<1% of mesenteric aneurysms) and often linked to infective endocarditis, carrying high rupture and mortality risks. We report a 53-year-old man with prior mitral and aortic valve replacement for Streptococcus mutans endocarditis, found incidentally to have a 2.1-cm saccular SMA aneurysm on computed tomography angiography. Given its infected appearance and complex branching, open resection with reversed saphenous vein interposition graft was performed. Recovery was uneventful. This case highlights early recognition, imaging, and the role of open repair in infected, anatomically challenging SMA aneurysms.