2021 Volume 30 Issue 6 Pages 341-345
Isolated dissecting aneurysm of superior mesenteric artery (IDSMA) is a rare entity with limited studies about its treatment. We report a successful surgical case of chronic IDSMA. The patient was a 66-year-old man who had an incidentally found superior mesenteric artery aneurysm with a diameter of 30 mm. Enhanced CT scanning revealed that the dissection started at a distance of 25 mm from the origin of SMA and the false lumen had become aneurysmal changed. The middle colic artery and the jejunum artery branched from the narrowed true lumen and the right colic artery and the ileocolic artery branched from the aneurysmal false lumen. After the midline laparotomy, the aneurysm was opened and the vascular reconstruction using the great saphenous vein (GSV) was performed after the establishment of the connection between the femoral artery and the peripheral end of the aneurysm. After the proximal anastomosis of GSV with the entry of the false lumen, a branch of ileocolic artery and the right colic artery were reconstructed and the peripheral end of the aneurysm was oversewn and closed. Postoperative course was uneventful. Our surgical technique using the entry of the false lumen as the proximal anastomosis can preserve the blood flow of the true lumen and useful for the surgical treatment of IDSMA.
