Intra-abdominal Hemorrhage Due to Rupture of a Mycotic Jejunal Artery Pseudoaneurysm in a 37-year-old Patient with Klebsiella Pneumoniae Endocarditis on Prosthetic Cardiac Valves: A Case Report

Abstract

Visceral artery aneurysms (VAAs) are defined as aneurysms affecting the celiac, superior, or inferior mesenteric arteries and their branches. The incidence rate of aneurysms of superior mesenteric artery (SMA) and its branches is exceptionally infrequent, with only a handful of cases ever reported. Mycotic aneurysms (MA) in the context of infective endocarditis (IE) are also uncommon, particularly for Klebsiella Pneumonie species etiology. Hereby, it is presented a case of a 37-year-old male with previous prosthetic heart valves for IE who developed recurrent IE and furthermore presents with intra-abdominal hemorrhage due to a ruptured jejunal artery MA with Klebsiella Pneumoniae. The patient was surgically managed with resection of the MA and segmental bowel resection with anastomosis. The postoperative outcome was uneventful. Mycotic jejunal artery pseudoaneurysm in the context of IE on prosthetic heart valves is an exceptional appearance, particularly with Klebsiella Pneumoniae spp. etiology. In case of ruptured mycotic jejunal artery pseudoaneurysm surgery is usually required, particularly in the context of hemoperitoneum or intestinal ischemia.