A Case of Splenic Artery-Superior Mesenteric Artery Bypass for Chronic Superior Mesenteric Artery Occlusion

Yousuke Kinjo, Mami Yoshitomi, Syugen Kan and Hidekazu Yamamoto

Department of Surgery, Saiseikai Izuo Hospital

A 62-year-old man with generalized atherosclerotic disease and atrial fibrillation seen for postprandial abdominal pain was found in enhanced computed tomography to have proximal superior mesenteric artery (SMA) occlusion and reconstituted mid and distal SMA via collaterals. Post-fasting, he was symptom-free, but postgrandial abdominal pain severity increased, necessitating mesenteric artery reconstruction requiring preoperative consideration of surgical alternatives, including conventional bypass grafting from the supraceliac aorta and iliac artery. We decided to provide SMA inflow via the splenic artery due to his recent iliac artery bypass grafting and aortic calcification. Current open surgical intervention involves arterial bypass using a vein or graft with aorta or iliac artery inflow and bypass to the SMA, in which the splenic artery provides an additional treatment option for revascularizing the SMA.

Key words
chronic mesenteric ischemia, mesenteric artery occlusion

Reprint requests
Yousuke Kinjo Division of Gastrointestinal Surgery, Department of Surgery, Kyoto University Graduate School of Medicine
54 Kawahara-cho, Shogoinn, Sakyo-ku, Kyoto, 606-8507 JAPAN

Accepted
May 19, 2010

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