Ruptured jejunal artery aneurysm

Costa, Sílvia; Costa, A. C.; Pereira, Tiago; Maciel, Jorge

doi:10.1136/bcr-2013-008772

Cited by 7 publications

(8 citation statements)

References 8 publications

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“…Surgical management has historically relied on simple arterial ligation or aneurysm excision without reconstruction. 56,87,140,169,184,185 This remains a conservative option for rupture, in which case exploratory laparotomy facilitates the evacuation of hematoma, definitive aneurysm treatment, and bowel assessment for viability. Enterectomy or colectomy may be required as intramural aneurysms and those associated with bowel necrosis require resection of the involved bowel at the time of aneurysm exclusion.…”

Section: (Weak) B (Moderate)mentioning

confidence: 99%

The Society for Vascular Surgery clinical practice guidelines on the management of visceral aneurysms

Chaer

Abularrage

Coleman

et al. 2020

Journal of Vascular Surgery

356

408

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Section: (Weak) B (Moderate)mentioning

confidence: 99%

The Society for Vascular Surgery clinical practice guidelines on the management of visceral aneurysms

Chaer

Abularrage

Coleman

et al. 2020

Journal of Vascular Surgery

356

408

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“…The above-mentioned key words yielded a total of 103 cases in 100 patients from 60 manuscripts [ 4 , 6 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 ,...…”

Section: Resultsunclassified

Crohn’s Disease and Jejunal Artery Aneurysms: A Report of the First Case and a Review of the Literature

et al. 2022

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Background and Objectives: Jejunal artery (JA) and ileal artery (IA) aneurysms constitute less than 3% of all visceral artery aneurysms (VAAs), carrying a risk of rupture as high as 30%, and a mortality of 20%. Though many etiologies have been reported in the literature, no mention exists on a causal association between these aneurysms and inflammatory bowel diseases (IBD). We present the first case of a JA aneurysm related to Crohn’s Disease (CD) together with a review of the literature. Materials and Methods: A 74-year-old male presenting with CD intestinal relapse and an incidental finding at the computed tomography enterography (CTE) of a 53 × 47 × 25mm apparently intact JA pseudoaneurysm, arising from the first and second jejunal branches, underwent coil embolization followed by small bowel resection, with an uneventful outcome. We also included the review of literature on JA and IA aneurysms, analyzing all reports published in PubMed and Scopus from 1943 to July 2022. Results: 60 manuscripts with 103 cases of JA and IA aneurysms in 100 patients were identified. Among cases with available data, 34 (33.0%) presented acutely with rupture, 45 (43.7%) were described as non-ruptured. 83 (80.6%), and 14 (13.6%) were JA and IA aneurysms, respectively, having a median size of 15 (range:3.5–52) mm. Atherosclerosis (16.5%), infections (10.7%), and vasculitides/connective tissue disorders (9.7%) represented the main causes mentioned. Mean age was 53.6 (±19.2) years, male patients being 59.4%. One third of patients (32.4%) were asymptomatic. Overall, treatment was indicated in 63% of patients, with surgery and endovascular procedures performed in 61.9% and 38.1% cases, respectively. The technical success rate of endovascular treatment (EVT) was 95.8%. The mortality rate was 11.8%, being higher (21.2%) in the rupture group. Conclusions: The prompt treatment accomplished in our case granted a successful outcome. JA and IA aneurysms should be included among local complications of IBD. Considering their high potential for rupture, regardless of size, a low threshold for endovascular or surgical treatment should be applied.

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“…Clinical reports of visceral artery aneurysms have increased; therefore, the most common sites of visceral artery aneurysm have been investigated . The majority of ruptured visceral artery aneurysms are in the splenic artery, followed by the gastroduodenal artery, the hepatic artery, the superior mesenteric artery, and the celiac axis, but ruptured aneurysms of the gastric artery are quite rare . Most ruptured visceral artery aneurysms are pseudoaneurysms .…”

Section: Discussionmentioning

confidence: 99%

“…Although transcatheter arterial embolization is widely accepted as a suitable and less invasive procedure for treating unruptured visceral artery aneurysms , the procedure is technically demanding for ruptured aneurysms, and the potential for re‐rupture exists . When circulatory dynamics are unstable, despite fluid therapy, because of rupture of the visceral artery aneurysm, a surgical approach is reliable and required .…”

Section: Discussionmentioning

confidence: 99%

“…Transcatheter arterial embolization is recognized as a suitable procedure to treat unruptured visceral artery aneurysms , but it is considered to be a potentially difficult procedure for the treatment of ruptured aneurysms . When transcatheter arterial embolization cannot be achieved, a surgical approach is required to treat ruptured visceral artery aneurysms .…”

Section: Introductionmentioning

confidence: 99%

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Laparoscopic surgery for the treatment of a ruptured aneurysm of the right gastric artery: a case report

Toyoda¹,

Kyokane²,

Kawai³

et al. 2016

Asian J Endoscop Surgery

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Laparoscopic surgery for the treatment of a ruptured visceral artery aneurysm is recognized as a challenging procedure. Here, we describe our experience with laparoscopic surgery to treat a ruptured aneurysm of the right gastric artery. A 72-year-old woman was diagnosed with intra-abdominal hemorrhage caused by a ruptured aneurysm of the right gastric artery. Transcatheter arterial embolization failed because the right gastric artery could not be cannulated. Therefore, we performed laparoscopic surgery. Using laparoscopy, we detected that the bleeding from the aneurysm had ceased; thus, the planned procedure was successful. The operative time and intraoperative blood loss were 100 min and 5 mL, respectively. The patient was discharged 7 days after surgery. Laparoscopic surgery after the failure of transcatheter arterial embolization is a suitable and safe procedure for ruptured visceral artery aneurysms, provided the circulatory dynamics are stable as a result of the temporary cessation of bleeding from the ruptured aneurysm.

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Ruptured jejunal artery aneurysm

Cited by 7 publications

References 8 publications

The Society for Vascular Surgery clinical practice guidelines on the management of visceral aneurysms

The Society for Vascular Surgery clinical practice guidelines on the management of visceral aneurysms

Crohn’s Disease and Jejunal Artery Aneurysms: A Report of the First Case and a Review of the Literature

Laparoscopic surgery for the treatment of a ruptured aneurysm of the right gastric artery: a case report

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