Al Harthy Ahmed, Belot Alexandre, Feugier Patrick
Service de Chirurgie Vasculaire et Endovasculaire, Hôpital Lyon Sud, Hospices Civils de Lyon, Lyon, France.
Service de Néphrologie-Rhumatologie-Dermatologie Pédiatriques, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Lyon, France.
EJVES Vasc Forum. 2022 Jan 10;54:36-39. doi: 10.1016/j.ejvsvf.2022.01.002. eCollection 2022.
Superior mesenteric artery (SMA) pseudoaneurysm is a very rare condition, typically associated with trauma, inflammation, and infection, and as a post-operative complication. If left untreated it can lead to serious consequences such as rupture and fatal haemorrhage.
A 17 year old male presented to the emergency department with a history of intermittent progressive epigastric pain with no preceding significant symptoms of a possible cause. He was initially treated conservatively until the intensity of pain was so severe an abdominal computed tomography (CT) scan was justified. A pseudoaneurysm of the SMA was found. Full inflammatory and immunological workup was unremarkable. Repeat CT scan showed the SMA pseudoaneurysm was larger, mandating surgical intervention; the vascular surgeon suggested an exploratory laparotomy. Intra-operatively, unexpectedly, a wooden foreign body measuring 5.0 × 0.3 × 0.5 cm was seen once the aneurysm sac was opened. The pseudoaneurysm was repaired and the abdomen closed after ascertaining that all other organs were intact. The patient had a simple recovery with no complications and was discharged home. The follow up CT scans were unremarkable.
Pseudoaneurysm of the SMA in the paediatric age group is an extremely rare and life threatening phenomenon. The clinical presentation may be subtle, leading to delayed diagnosis. Early surgical intervention may be lifesaving and prevent further complications.
肠系膜上动脉（SMA）假性动脉瘤是一种非常罕见的病症，通常与创伤、炎症、感染有关，也可作为术后并发症出现。若不治疗，可能会导致严重后果，如破裂和致命性出血。
一名17岁男性因间歇性进行性上腹部疼痛前来急诊科就诊，之前没有明显的可能病因相关症状。他最初接受了保守治疗，直到疼痛加剧，才进行腹部计算机断层扫描（CT）。结果发现了肠系膜上动脉假性动脉瘤。全面的炎症和免疫检查结果无异常。重复CT扫描显示肠系膜上动脉假性动脉瘤增大，需要进行手术干预；血管外科医生建议进行剖腹探查术。术中，意外的是，打开动脉瘤囊后发现了一个尺寸为5.0×0.3×0.5厘米的木质异物。修复假性动脉瘤后，确认所有其他器官完好无损，然后关闭腹腔。患者恢复顺利，无并发症，出院回家。后续CT扫描结果无异常。
小儿肠系膜上动脉假性动脉瘤是一种极其罕见且危及生命的现象。临床表现可能不明显，导致诊断延迟。早期手术干预可能挽救生命并预防进一步并发症。
