Presentation of a large jejunal artery aneurysm: Management and review of the literature

Abstract

HighlightsJAAs are rare and constitute 1% of all VAAs.The widespread of diagnostic imaging techniques has increased the number of JAAs diagnosed incidentally.Visceral artery aneurysms present a rate of rupture of 10–20%. Most of cases of JAAs reported presented rupture at diagnosis.Symptomatic JAAs and those intact greater than 2 cm must be treated. However, recently the limit of 2 cm has been questioned.Surgery is especially useful in emergency. On the other hand, embolisation and stents are promising options.

Surgical Treatment of Jejunal Artery Aneurysm

“… 1 , 2 , 3 JAAs are associated with a 30% risk of rupture and a 10–20% mortality rate, 2 therefore, it is generally considered that all symptomatic and isolated visceral artery aneurysms greater than 2 cm in diameter should be treated. 4 …”

“…In elective cases, both open and endovascular repair have shown positive results. 1 , 2 , 3 , 4 , 7 , 8 , 9 It is evident that endovascular repair is less invasive compared with open repair. According to Sachdev et al., there was no significant difference between open repair and endovascular repair regarding mortality, post-operative complications, and re-intervention.…”

“…excised a huge aneurysm and ligated the inflow and outflow vessels with a good result. 4 It is unclear which technique leads to better outcome, excision only or revascularisation. Generally, sufficient blood flow can be expected with collateral circulation and, in fact, there was no sign of intestinal ischaemia when the distal end of the aneurysm was clamped.…”

“…Generally, sufficient blood flow can be expected with collateral circulation and, in fact, there was no sign of intestinal ischaemia when the distal end of the aneurysm was clamped. 1 , 2 , 3 , 4 The advantage of open repair is that intestinal ischaemia can be assessed directly. For complete elimination of uncertainty about further intestinal ischaemia, the jejunal artery was reconstructed by saphenous vein graft without difficulty.…”

“…short neck, tortuous aorta) still require open repair. 1 , 3 , 4 This study is a report of a case of saccular aneurysm located in the proximal jejunal artery that was repaired with saphenous vein graft interposition.…”