The Diagnosis and Endovascular Management of Superior Mesenteric Artery (SMA) Branch Pseudoaneurysms After Appendicectomy

Zia, Zahra; Thurley, Peter; Pollock, John G.; DeNunzio, Mario; Bungay, Peter M.; Whitaker, Simon

doi:10.1177/1538574411425109

Cited by 5 publications

(5 citation statements)

References 13 publications

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“…As it is minimally invasive and has a high success rate and low mortality rate, it is widely used to treat pseudoaneurysm [14]. In both our case and the cases reported by Zia et al [6], pseudoaneurysm was suspected on CT imaging, and a definitive diagnosis and treatment were achieved by angiography. It is common to evaluate by CT at the time a pseudoaneurysm is suspected and then to perform angiography as a diagnostic treatment.…”

Section: Discussionsupporting

confidence: 57%

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Ruptured ileocolic artery pseudoaneurysm after laparoscopic appendectomy for acute appendicitis

et al. 2022

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Background A pseudoaneurysm of the splanchnic vessels is considered to be rare, and in particular, very few cases of pseudoaneurysm in the ileocolic artery are reported. Here, we report a case of rupture of a pseudoaneurysm of the appendicular branch of the ileocolic artery after laparoscopic appendectomy. Case presentation A 52-year-old man was diagnosed as having phlegmonous appendicitis, and an emergency laparoscopic appendectomy was performed. Bleeding from the inter-appendicular ligament during detachment of adhesions was stopped by white coagulation and Z-suture, and the inter-appendicular ligament was treated. The postoperative course was uneventful, and there were no adverse events or findings suggestive of abscess formation. On postoperative day 30, he presented with a ruptured pseudoaneurysm of the appendicular branch of the ileocolic artery. A definitive diagnosis was made by computed tomography, and emergency interventional radiology was performed with hemostasis achieved by coiling. The patient’s postprocedure course was favorable, and he was discharged with no adverse events, such as intestinal ischemia. Conclusions We experienced a case of delayed pseudoaneurysm rupture after laparoscopic appendectomy. Care must be taken when handling the appendicular artery during the procedure, and the potential for pseudoaneurysm formation should be considered at postoperative follow-up.

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Section: Discussionsupporting

confidence: 57%

“…Reports of pseudoaneurysm are very rare after an appendectomy. To the best of our knowledge, only two cases have been reported so far by Zia et al [6]. The most frequently reported lesions were in the splenic vein, gastroduodenal artery, and pancreaticoduodenal artery [7], with only a few reports of pseudoaneurysm in the SMA.…”

Section: Discussionmentioning

confidence: 93%

Ruptured ileocolic artery pseudoaneurysm after laparoscopic appendectomy for acute appendicitis

et al. 2022

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“…Mesenteric angiography is the gold standard test, but the initial diagnosis is often made by CT with intravenous contrast. 14,15 Arterial cuts and delayed cuts are valuable as the pseudoaneurysm sac may be conclusively identified by filling during the arterial phase and emptying thereafter. CT angiography has a sensitivity and specificity of 94.7% and 90%, respectively, in detecting visceral pseudoaneurysms.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and Management of Ileocolic Pseudoaneurysms

Desai¹,

Dua²,

Shortell³

et al. 2012

Perspectives in Vascular Surgery and Endovascular Therapy

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Ileocolic pseudoaneurysmal disease is a rare splanchnic aneurysm that affects 3 out of 100 000 patients, and only 7 cases have been described in the past 40 years in patients without preexisting connective tissue disorders. Abdominal pain is the most common presenting symptom and nearly 30% of patients present with hemorrhage. Ileocolic pseudoaneurysms are diagnosed by contrasted computed tomography scans and verified by arteriography. We present a case report and review of the literature in which a patient was initially managed by coil embolization, followed by laparotomy and suture ligation due to pseudoaneurysm rupture.

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“…Treatment strategies differ for mycotic aneurysms (14), necessitating surgical intervention due to the introduction of foreign bodies such as stents, coils, or liquid embolisates being unsuitable for primarily infected tissue (25,26). In critical conditions where general anesthesia or surgical procedures are not viable, the minimally invasive endovascular procedure may be the preferred method, even for mycotic aneurysms (17,18).…”

Section: Minimally Invasive Endovascular Transcatheter Treatmentmentioning

confidence: 99%

Transarterial Embolization of Visceral Artery Aneurysms

Mertineit,

Buitrago Tellez,

Kissling

et al. 2024

Swiss J Rad Nucl Med

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The management of an aneurysm or pseudoaneurysm, including decisions regarding how, when, and with what method it should be treated, must always be determined through interdisciplinary consensus grounded in a thorough understanding of the existing literature. Consequently, today's preferred approach is embolization therapy or covered stenting. This method, performed in a minimally invasive manner, has been well-established due to its methodical low invasiveness and high eﬀectiveness in achieving both technical and clinical success. It stands as a prominent choice among the available surgical and minimally invasive therapy options. The procedure, executed with advanced technology, utilizes the latest catheters and wires, coupled with expertise in various embolization methods. This comprehensive approach enables the treatment of acute bleeding in emergency cases, ensuring a nuanced and eﬀective response (9-13).

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The Diagnosis and Endovascular Management of Superior Mesenteric Artery (SMA) Branch Pseudoaneurysms After Appendicectomy

Cited by 5 publications

References 13 publications

Ruptured ileocolic artery pseudoaneurysm after laparoscopic appendectomy for acute appendicitis

Ruptured ileocolic artery pseudoaneurysm after laparoscopic appendectomy for acute appendicitis

Diagnosis and Management of Ileocolic Pseudoaneurysms

Transarterial Embolization of Visceral Artery Aneurysms

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