Ruptured inferior mesenteric artery aneurysm in a patient with neurofibromatosis type I and its management

Abstract

Inferior mesenteric artery aneurysm is very rare and are usually asymptomatic. A high mortality is associated with aneurysmal rupture. The purpose of this paper is to report occurrence of a rare disease and its treatment options. A 64 years old woman presented with complaints of lower abdominal pain radiating to back for 1month, with non-passage of stools for 5days, and had decreased appetite. She had features of Neurofibromatosis type I. On examination, she had tachycardia and had pallor, and abdominal examination showed lumps in right and left iliac fossa which progressively increased in size. Computed tomography scan showed features of leaking inferior mesenteric artery aneurysm with perianeurysmal hematoma. The patient was taken up for surgical exploration wherein after checking the bowel viability, the inferior mesenteric artery was clipped at its origin, ligated and divided followed by hematoma evacuation. Post-operative stay was uneventful, and the patient was discharged on post-operative day 10.

Robotic resection for splenic artery aneurysm associated with neurofibromatosis type 1: a case report

“…In contrast, in a report examining 40 aneurysm lesions associated with NF1, there were only two cases involving the liver artery, one case involving the gastroduodenal artery, and one case involving the pancreaticoduodenal artery, indicating that abdominal visceral aneurysms are rare [ 9 ]. There have been several reports of abdominal visceral aneurysms associated with NF1, including liver, superior mesenteric, inferior mesenteric, celiac, gastroduodenal, and superior rectal arteries [ 4 – 6 , 9 , 19 – 34 ] (Table 1 ). However, to our knowledge, there are no reports of splenic aneurysms associated with NF1 in the relevant English literature, and we believe that this is the first report of such an aneurysm.…”

“…The spectrum of vasculopathy in NF1 includes aneurysms, stenosis, and arteriovenous malformations of medium- and large-sized vessels. Although there have been some reports of abdominal visceral arteries such as the liver artery, superior mesenteric artery (SMA), and inferior mesenteric artery (IMA) [ 4 – 6 ], there have been no reports of splenic artery aneurysms, and this is believed to be the first reported aneurysm of this type worldwide.…”