A Successfully Treated Case of Rectal Carcinoma with a Concomitant Asymptomatic Middle Colic Artery Aneurysm

Abstract

A 77-year-old woman with melena was referred to our hospital. Colonoscopy showed an advanced rectal cancer located approximately 3 cm from the anal verge. Abdominal contrast-enhanced computed tomography (CT) showed an asymptomatic aneurysm, 8 mm in diameter, at the root of the middle colic artery. The patient underwent abdominoperineal excision of the rectal cancer, and the aneurysm of the middle colic artery was also resected in view of the high risk of rupture. The middle colic artery was then reconstructed by end-to-end anastomosis to preserve blood flow to the left side of the colon. Postoperative CT angiography demonstrated patency of the reconstructed artery, and the patient's postoperative course was uneventful. The therapeutic strategy for asymptomatic visceral aneurysms remains unclear, especially in patients who are scheduled for abdominal surgery. In this situation, intervention for the aneurysm depends on various issues, such as the location of the aneurysm, the risk of rupture, the primary disease status, and whether reconstruction is required.