Akkary Ehab, Cramer Tonya, Patel Miral, Kanthimathinathan Venkat, Phan Thanh
Preston Memorial Hospital, Kingwood, WV, USA.
W V Med J. 2010 Nov-Dec;106(7):10-4.
Superior mesenteric artery aneurysms (SMAAs) are visceral arterial aneurysms that can result from a variety of conditions. About half of SMAAs are mycotic and occur subsequent to infective endocarditis. The clinical presentation of SMAA is nonspecific, and some patients may be asymptomatic while others may report mild to severe abdominal pain. Herein, we present a case of a 53-year-old man who presented to the emergency department with abdominal pain 5 months after receiving medical treatment for infective endocarditis. CT scan demonstrated an aneurysm in the superior mesenteric artery and a splenic infarct. The patient underwent surgical excision with an uneventful recovery. Although rare, SMAAs are associated with a high risk of death secondary to rupture. They are difficult to detect through physical examination and the history is usually nonspecific. In this report we discuss the etiology of SMAA, diagnostic work-up and treatment options aiming for early diagnosis and management of this potentially fatal condition.
