A Case of Inferior Mesenteric Two year after Sigmoidectomy

Yusuke Uno, Kenji Kobayashi, Seiji Ogiso, Yoshichika Okamoto, Akira Ishikawa and Kazuhisa Akahane

Department of Surgery, Chubu Rosai Hospital

We report the case of a 72-year-old man in whom an inferior mesenteric artery aneurysm occurred 2 years after colon cancer surgery. He was admitted for melena in October 2006, and had a history of sigmoidectomy for sigmoid colon cancer in October 2004 without recurrence of the cancer. Abdominal CT showed a mass 28 mm in diameter on the left side of the left common iliac artery, continuing to the inferior mesenteric artery. Colonoscopy showed a blood lump near the anastomosis of previous surgery, but the bleeding point could not be detected. We diagnosed the case as inferior mesenteric artery aneurysm penetrating the intestinal tract. After hospitalization, the patient went into shock due to melena, necessitating emergency surgery. An aneurysm was palpated at the mesentery in the proximity of the colonic anastomosis and we found that the small intestine had adhered to the aneurysm. We conducted aneurysmectomy with resection of colonic anastomosis and the adhering part of the small intestine. Inferior mesenteric artery aneurysm is rare, and we report this case with a review of the literatures.

Key words
pseudoaneurysm, inferior mesenteric arery, colon cancer

Reprint requests
Yusuke Uno Department of Surgery, Daido Hospital
9 Hakusui-cho, Minami-ku, Nagoya, 457-8511 JAPAN

Accepted
February 20, 2008

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