%0 Journal Article
%T Endovascular treatment of a Superior Mesenteric Artery Syndrome variant secondary to traumatic pseudoaneurysm
%A Iain Au-Yong
%A Nicholas FS Watson
%A Catherine L Boereboom
%A Timothy E Bowling
%A John F Abercrombie
%A Simon C Whitaker
%J World Journal of Emergency Surgery
%D 2010
%I BioMed Central
%R 10.1186/1749-7922-5-7
%X Superior mesenteric artery pseudoaneurysm is a rare but recognised complication of traumatic injury to the artery [1-8]. It is caused by a full thickness breach of the artery wall. Other recognised causes include pancreatitis and iatrogenic events. It may also occur spontaneously. The condition is important as the risk of rupture is high and carries a significant mortality rate [1].Superior mesenteric artery syndrome is more widely recognised, and results from obstruction of the duodenum where it passes between the superior mesenteric artery and aorta, by any process which narrows the angle between these two structures [9]. In its commonest form it is not associated with an acquired structural abnormality: the angle between the SMA and aorta is constitutionally narrowed. In its best-known acquired variant, the aortoduodenal syndrome, the duodenum is compressed between the SMA and an abdominal aortic aneurysm [10]. This case is unique, comprising both the first description of a variant of SMA syndrome caused by a traumatic SMA pseudoaneurysm and the first account of successful treatment of both the aneurysm and duodenal obstruction by endovascular stent placement.Our 40 year-old male patient was the driver of a vehicle that collided at high speed with a fence post. He was transferred via air ambulance to hospital and on arrival was conscious and alert. Marked anterior abdominal wall bruising was evident consistent with injury relating to use of a lap belt, and he complained of diffuse abdominal pain. Abdominal computerised tomography (CT) demonstrated free intraperitoneal fluid. At laparotomy, approximately 3000 mls of haemoperitoneum was evacuated and devascularising mesenteric injuries were noted affecting segments of jejunum, terminal ileum, caecum and sigmoid colon (American Association for the Surgery of Trauma Grade 4 injuries). A subtotal colectomy with ileo-sigmoid anastamosis and resection of 10 cm of mid-jejunum was performed.Postoperative recovery was prol
%U http://www.wjes.org/content/5/1/7