Ultrasound Demonstration of a Superior Mesenteric Artery Aneurysm in a Patient With Ehlers-Danlos Syndrome

Cremers, P. T. J.; Busscher, D. L. T.; Macfarlane, J. D.

doi:10.1093/rheumatology/29.6.482

Cited by 10 publications

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several reports [7][8][9][10] have revealed mycotic aneurysm to be associated with infectious endocarditis. SMA aneurysms have been reported with congenital etiology [12] and in association with Ehlers-Danlos syndrome [13]. The patient in this case had no predisposing disease except tetanus and hypertension.…”

Section: Discussionmentioning

confidence: 71%

Ruptured superior mesenteric artery aneurysms during treatment of tetanus: a case report

Takahashi

Matsumiya

Tanaka

et al. 2000

Journal of Anesthesia

View full text Add to dashboard Cite

toxoid, human tetanus immunoglobulin, and penicillin G intravenously as the usual treatment. Although he was conscious and alert, he exhibited signs of lockjaw, which progressed to opisthotonos 10 h after admission. The patient's muscle spasms became so severe that it was necessary to intubate his trachea, using intravenous midazolam and vecuronium bromide to allow controlled ventilation.After the onset of severe muscle spasms, cardiovascular instability occurred frequently. Despite the administration of intravenous diltiazem hydrochloride 5 mg hourly and nicardipine 1 mg as required, the patient's hemodynamic state remained unstable, and his systolic blood pressure exceeded 200 mmHg on several occasions. His condition was classified as very severe tetanus, as graded by modified Ablett's classification [1,2].One week following admission, the patient suddenly developed hypotension and tachycardia (Fig. 1). Although he had often shown the alternate hypertension and hypotension caused by sympathetic storm, we suspected hemorrhagic hypotension in this situation. This suspicion was confirmed by a decrease in hemoglobin concentration from 12.5 to 10.7 g·dl Ϫ1 after fluid resuscitation. A massive intraperitoneal hematoma was detected by abdominal ultrasonography and computed tomography. The emergency arteriography showed bleeding from multiple SMA aneurysms (Fig. 2). We used a 5-Fr catheter (Mallinckrodt) via the right femoral artery. Embolization was then performed with eight coils Cook), gelatine (Gelfoam), and 3-0 silk strings. After embolization for the aneurysms of the main trunk, the patient's hemodynamic state returned to a normal range (Fig. 2).Temporary paralytic ileus resulted from the embolization and the peritoneal hematoma, requiring treatment with sodium picosulfate orally, panthenol and dinoprost (PGF 2α ) intravenously, and glycerin

show abstract

Section: Discussionmentioning

confidence: 71%

Ruptured superior mesenteric artery aneurysms during treatment of tetanus: a case report

Takahashi

Matsumiya

Tanaka

et al. 2000

Journal of Anesthesia

View full text Add to dashboard Cite

show abstract

“…In addition to this case report, there are nine published cases of visceral artery aneurysms in patients with EDS type IV (Table ). [17][18][19][20][21][22][23] Of these nine cases, two occurred in isolation, whereas the remainder occurred in association with other arterial aneurysms, visceral or otherwise. The aneurysms were asymptomatic in three cases, and they were seen with acute hemorrhagic episodes in another three.…”

Section: Discussionmentioning

confidence: 99%

Visceral aneurysms in Ehlers-Danlos syndrome: Case report and review of the literature

Parfitt

Chalmers

Wolfe

2000

Journal of Vascular Surgery

View full text Add to dashboard Cite

A patient with Ehlers-Danlos syndrome type IV had a celiac artery aneurysm. There are only nine previously published cases of visceral artery aneurysms in this condition, and surgical management was used in only four of them. This is, we believe, the first published report of a successfully treated celiac artery aneurysm in this condition in which the hazards of treatment and our rationale are explained. The literature of this rare problem is also reviewed.

show abstract

Aneurysm of superior mesenteric artery: Identification with ultrasonography

Honarbakhsh

Madjlessi

Davaii

et al. 1993

J of Clinical Ultrasound

View full text Add to dashboard Cite

A true aneurysm is an abnormal widening of a blood vessel that involves all three layers of vessel wall. The basic defect is destruction of elastic fibers in the media, which permits the remaining fibrous tissue to stretch and leads to an increase in diameter. Aneurysms are fusiform with a segment of the vessel becoming diffusely dilated, its total circumference being involved. In contrast, saccular aneurysms affect a portion of the circumference and consist of an outpouching with a mouth.The most common underlying cause is arteriosclerosis, but cystic medial necrosis, trauma, and syphylis and other infections must also be considered as a cause.' The case reported here underlines the importance of ultrasound identification of the lesion. CASE REPORTA 17-year-old young man was seen because of severe abdominal pain of sudden onset. The pain was constant and spread over the whole abdomen. His past history was positive for such pain, but less severe and without correlation to meals. He practiced karate but didn't mention recent abdominal trauma.Physical examination revealed a well developed, well nourished young man with thin skin. The sclera was slightly bluish. No lymphadenopathy was found. There was a round, mobile (partially) and pulsatile abdominal mass at the left epigastrium. Liver and spleen were not palpated. Hyperextensibility of the first metacarpophalangeal joint was noted, which was mentioned to have existed from childhood. Laboratory tests were all at normal range. Plain abdominal X-ray showed no abnormality.An abdominal ultrasonography was performed. The scanner used was EUB-40 ultrasound imaging system (Hitachi, Japan). The transducer was a 3.5 MHZ, convex type.Two dimensional B-mode images were obtained using standard planes and rules. The liver, gall bladder, biliary duct, and pancreas were all normal. The spleen was not enlarged. Evaluation of the retroperitoneal area revealed a well-defined, ovoid, echo-free lesion (27 mm long, 10 to 15 mm wide) adjacent t o the aorta ( Figure 1). The sagital view showed that it was a fusiform dilatation of the superior mesenteric artery (Figure 2). A selective superior mesenteric arteriogram (Figure 3) proved the diagnosis of an SMA aneurysm.

show abstract

Ultrasound Demonstration of a Superior Mesenteric Artery Aneurysm in a Patient With Ehlers-Danlos Syndrome

Cited by 10 publications

References 0 publications

Ruptured superior mesenteric artery aneurysms during treatment of tetanus: a case report

Ruptured superior mesenteric artery aneurysms during treatment of tetanus: a case report

Visceral aneurysms in Ehlers-Danlos syndrome: Case report and review of the literature

Aneurysm of superior mesenteric artery: Identification with ultrasonography

Contact Info

Product

Resources

About