Diagnosis and treatment of infective aneurysm of mesenteric artery due to infective endocarditis

Abstract

Background The incidence of infected aneurysms is low. Risk factors include atherosclerosis, arterial damage as well as previous infection. The different types of infected aneurysms, infective endocarditis still accounts for a larger proportion. The diagnosis and treatment methods have not been standardized yet. Case presentation: A 25-year-old young man presented with a fever (up to 39.0°C). Even after three months, the fever persisted and included abdominal pain and diarrhea. CT angiography of the thoracoabdominal aorta suggested the formation of a pseudoaneurysm, potentially a branch of the superior mesenteric artery. Considering the patient's presence of distant infarction and the formation of infectious pseudoaneurysm, the patient underwent early surgery. The patients underwent aortic valve replacement and partial small bowel resection. The coagulation function was monitored in the outpatient clinic after the operation, and the patient returned to normal life during the postoperative follow-up. Conclusions In patients with a history of endocarditis and a chief complaint of abdominal pain and fever, embolism due to septic embolic drop should be included in the differential diagnosis. Before the onset of symptoms, patients should be treated prophylactically, preventing surgical treatments such as bowel resection.