Revascularization by Internal Iliac Artery Graft in a Case of Superior Mesenteric Aneurysm

Junichi Shimada, Hideyuki Kawachi, Kenji Tsukamoto, Shuji Shirakata, Koichi Oga, Takahiro Oka

The Second Department of Surgery, Kyoto Prefectural University of Medicine

Superior mesenteric aneurysm is a rare condition and its diagnosis is frequently difficult. We recently encountered a patient with this condition who could be surgically treated on the basis of the preoperative diagnosis. The patient was a 51-year-old man who was admitted to our hospital because of repeated attacks of hypogastric pain for 3 months. Abdominal angiography revealed an aneurysm at the base of the superior mesenteric artery (SMA). Orthotopic revascularization was attempted by aneurysmectomy and internal iliac artery grafting. During and after the operation, blood flow through each SMA branch was monitored with an ultrasound blood flow meter. The excised aneurysm was histologically found to be an arteriosclerotic lesion (10×15 mm). In this case, an ultrasound blood flow meter was very useful in assessing run-off on the side distal from the obstructed point and in judging the viability of the intestinal tract. Arterial grafting was selected, with the expectation of long-term patency of the graft. The effectiveness of this technique will be assessed in the future.

Key words
superior mesenteric artery aneurysm, transit-time doppler blood flow meter, internal iliac artery graft

Reprint requests
Junichi Shimada The Second Department of Surgery, Kyoto Prefectural University of Medicine
Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602 JAPAN

Accepted
December 12, 1990

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