Christie Omari, Isaac Naomi, Hanumaiah Ravikumar
SUNY Upstate University Hospital, 750 E Adams St. Syracuse, NY 13210.
Touro College of Osteopathic Medicine, 60 Prospect Ave, Middletown, NY 10940.
Radiol Case Rep. 2022 Apr 10;17(6):2047-2051. doi: 10.1016/j.radcr.2022.03.057. eCollection 2022 Jun.
The etiology of large artery aneurysms has long been established as secondary to atherosclerotic disease and degenerative changes in the vessel walls. Less common, are aneurysms of the visceral arteries; the splanchnic and renal arteries. Rarer yet, are inferior mesenteric artery aneurysms, accounting for approximately 1% of visceral artery aneurysms. While causes range from inflammatory to congenital disease, a proposed etiology of proximal, solitary inferior mesenteric artery aneurysms, is correlated to the "jet disorder phenomenon," first described in a 1990 case report by Sugrue, and Hederman. This paradigm states that aneurysm formation may occur secondary to celiac and superior mesenteric artery occlusion, causing increased, and turbulent arterial flow distally. We present a case that demonstrates a small inferior mesenteric artery aneurysm without findings of celiac or superior mesenteric artery stenosis or occlusion. This patient did, however, have a large thrombosed common hepatic artery aneurysm which may serve as an alternate cause of jet disorder phenomenon. The findings in this case offers support for focused screening of proximal arterial vasculature when an inferior mesenteric artery aneurysm is encountered.
大动脉动脉瘤的病因长期以来一直被认为是继发于动脉粥样硬化疾病和血管壁的退行性变化。内脏动脉的动脉瘤较少见，如内脏和肾动脉。更罕见的是肠系膜下动脉动脉瘤，约占内脏动脉动脉瘤的1%。虽然病因范围从炎症性疾病到先天性疾病，但一种关于近端孤立性肠系膜下动脉动脉瘤的病因假说与“喷射紊乱现象”相关，该现象最早在1990年Sugrue和Hederman的病例报告中描述。该范例指出，动脉瘤形成可能继发于腹腔干和肠系膜上动脉闭塞，导致远端动脉血流增加和紊乱。我们报告一例病例，该病例显示一个小的肠系膜下动脉动脉瘤，未发现腹腔干或肠系膜上动脉狭窄或闭塞。然而，该患者有一个大的血栓形成的肝总动脉瘤，这可能是喷射紊乱现象的另一个原因。该病例的发现为遇到肠系膜下动脉动脉瘤时对近端动脉血管进行重点筛查提供了支持。
