Open reconstruction of multiple huge superior mesenteric artery aneurysms.

Open reconstruction of superior mesenteric artery aneurysms is very difficult, especially if the lesion is extensive. Aneurysmal lesions were found in a 74-year-old woman during a medical checkup. Computed tomography scan showed a 6.8-cm aneurysm arising 4 cm distal to the superior mesenteric artery origin, in succession to a 2.7-cm aneurysm, and further distal small aneurysms with string-of-beads appearance. The first, second, and third jejunoileal arteries, the middle colic artery, and the ileocolic artery were originated from the aneurysms. Open reconstruction was done using a branched saphenous vein graft. Computed tomography scan confirmed the patency of the grafts. She had no major troubles for another 4 years.