Cryptogenic mycotic aneurysm of the superior mesenteric artery

Kordzadeh, Ali; Kalyan, Jiten P.; Attila, Jonas; Hanif, M.; Prionidis, Ioannis

doi:10.1093/jscr/rjv106

Cited by 6 publications

(10 citation statements)

References 6 publications

(10 reference statements)

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“…It is difficult to estimate the true incidence rate of visceral aneurysms as there is a high rate of asymptomatic cases; however, it is thought that they account for 0.1-0.2% of aneurysms [1][2][3]. Splenic artery aneurysms make up the majority of visceral aneurysms, while SMA aneurysms make up just 5.5% [1,3].…”

Section: Discussionmentioning

confidence: 99%

“…Direct inoculation of bacteria occurs in vessels with abnormal intima [2]: either by a preceding infection, atherosclerosis, or a pre-existing aneurysm [3]. Mycotic or infectious causes are the most common aetiologies for the development of SMA aneurysms, with Streptococci being the most reported cause followed by Staphylococci [4].…”

Section: Discussionmentioning

confidence: 99%

“…Most cases of mycotic SMA aneurysms have diabetes mellitus as a risk factor [6]; however, our patient was not diabetic. The term "cryptogenic aneurysm" describes cases where no identifiable primary or secondary cause is found [2].…”

Section: Discussionmentioning

confidence: 99%

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Visceral Mycotic Aneurysm: Superior Mesenteric Artery Aneurysm Caused by K. pneumoniae

et al. 2021

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We herein report a rare case of mycotic aneurysm of the superior mesenteric artery caused by Klebsiella pneumoniae. A 66-year-old man, a known case of hypertension and aorto-oesophageal fistula with stented aorta in 2010 and 2018, presented to the emergency department multiple times over 2 months with severe postprandial abdominal pain associated with vomiting and fever. On his last presentation, the obtained blood cultures grew ESBL positive K. pneumoniae and a repeated computed tomography (CT) showed a growing aneurysm at the origin of the ileocecal branch of the superior mesenteric artery measuring 17 × 10 mm (the aneurysm was 8 × 7.5 mm in the CT angiography on the previous admission). Extensive workup did not reveal the underlying cause of the mycotic aneurysm, thus we believe the cause to be the infected aortic stent, leading to bacteraemia and vegetations to the mesenteric artery causing the aneurysm. The management plan was placed by a multidisciplinary team consisting of vascular surgeons and infectious disease specialists along with review from a dietician to evaluate the patient’s nutritional status. The patient was started on total parenteral nutrition due to his postprandial pain and on antibiotic therapy according to the infectious disease team’s recommendation. He underwent surgical resection of the mycotic aneurysm, which showed a thrombosed aneurysm in the jejunoileal mesenteric area. The histopathology of the resected tissue demonstrated inflammatory aneurysm of the mesenteric artery. Following the surgery, the patient continued his antibiotic therapy and was discharged on the 13th post-operative day with follow-up appointments in the vascular surgery and infectious disease clinic.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Visceral Mycotic Aneurysm: Superior Mesenteric Artery Aneurysm Caused by K. pneumoniae

et al. 2021

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“…She had personal history of atrial fibrillation, high blood pressure, grade V chronic kidney disease on hemodialysis, carotid artery stenosis, bilateral peripheral MA are rare and most commonly involve the superior mesenteric artery, representing only 10% of all visceral aneurysms, most commonly caused by atherosclerosis [2][3][4]. MA is associated with a high morbidity and mortality, estimated in 19% within 6 months of diagnosis despite surgical or endovascular intervention [5].…”

Section: Case Reportmentioning

confidence: 99%

Untitled

2018

Int J Radiol Imaging Technol

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“…Literatūroje taip pat nurodoma, kad dažniausios visceralinės aneurizmos yra blužnies, rečiau -kepenų, dar rečiau pažeidžia kitas arterijas [1,10,11,12,13,14,15].…”

Section: Aneurizmų Lokalizacijaunclassified

Visceralinių Aneurizmų Gydymo Patirtis Vilniaus Miesto Klinikinėje Ligoninėje

Kvietkauskas¹

2017

Medicinos Teorija Ir Praktika

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Reikšminiai žodžiai: visceralinės aneurizmos, aneurizmos plyšimas. Visceralinės aneurizmos yra reta patologija. Medicinos publikacijose apie visceralines aneurizmas dažniausiai pristatomi pavieniai klinikiniai atvejai, o ne tyrimai, paremti statistine duomenų analize. Straipsnyje pateikiama visceralinių aneurizmų gydymo Vilniaus miesto klinikinėje ligoninėje patirtis. Vilniaus miesto klinikinėje ligoninėje per pastaruosius 13 metų gydyti 6 pacientai, sergantys visceralinėmis aneurizmomis. Kadangi gydytų pacientų skaičius buvo per mažas, kad būtų galima atlikti statistiškai patikimus skaičiavimus, straipsnyje pateikiama aprašomoji analizė. Gydyti pacientai, sirgę įvairių lokalizacijų visceralinėmis aneurizmomis, kurios pasireiškė įvairia klinika. Diagnozė buvo nustatyta dažniausiai atsitiktinai, atlikus pilvo echoskopiją, rečiau – kompiuterinės tomografijos metodu. Patologija patikslinta ir invazinio gydymo taktika parinkta atlikus kompiuterinę tomografiją, o kai kuriais atvejais – ir angiografiją. Gydyti 4 asimptominėmis aneurizmomis sergantys pacientai, 1 – simptomine ir 1 – plyšusia. Taikytas tiek endovaskulinis, tiek operacinis gydymas. 3 gydyti pacientai pasveiko, 1 paciento būklė nepakito, 2 – mirė. Visceralinių aneurizmų diagnostiką apsunkina šiai patologijai būdinga nespecifiška klinika. Neatidėliotina ar skubi intervencija būtina siekiant sumažinti pacientų, sergančių atitinkamai simptominėmis arba plyšusiomis visceralinėmis aneurizmomis, mirtingumą. Operacinio gydymo rezultatai yra stabilesni, tačiau nuolat progresuojantis ir tinkamai taikomas endovaskulinis gydymas pamažu tampa pirmu pagal pasirinkimą gydymo metodu. Visceralinių aneurizmų diagnostikos ir gydymo patirtis bei iššūkiai Vilniaus miesto klinikinėje ligoninėje yra analogiški pateikiamiems kitose publikacijose, nagrinėjančiose šią patologiją.

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Cryptogenic mycotic aneurysm of the superior mesenteric artery

Cited by 6 publications

References 6 publications

Visceral Mycotic Aneurysm: Superior Mesenteric Artery Aneurysm Caused by <b><i>K. pneumoniae</i></b>

Visceral Mycotic Aneurysm: Superior Mesenteric Artery Aneurysm Caused by <b><i>K. pneumoniae</i></b>

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Visceralinių Aneurizmų Gydymo Patirtis Vilniaus Miesto Klinikinėje Ligoninėje

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