Splanchnic Aneurysms & Possible Etiology - Splanchnic Aneurysms & Possible Etiology - Open Access Pub

Four cases are reported with splanchnic aneurysms of the branches of the main arteries. Three of the cases presented as emergencies. Possible rupture was present in Case 2 and true rupture in Case 4. The etiology of Cases 1 and 2 may have been a floxacin antibiotics, Table 1. This report is the first clinical chronological association of the antibiotics and arterial and aortic pathology. This association was supported by nationwide research by Pasternak, 11. Detailed experimental work done on mice showed connective tissue fragmentation and arterial cell injury. Apparently, the above antibiotic induced mitochondrial DNA damage and dysfunction, 9. DOI10.14302/issn.2574-4526.jddd-19-2963 The patient in Cases 1 and 2 gives full permission for the use of his medical history and we have patient consents for Cases 3 and 4. An 84 year old male had an elective percutaneous stent graft treatment of right internal iliac aneurysm in 2014. The 4cm in diameter aneurysm had been detected as an incidental finding in 2011, Figure 1. The CT scan also revealed abdominal aortic and internal carotid dilatations as well as a small mesenteric aneurysm was also present. He had received a six day course of 400mg Avelox (Maxifloxacin) on December 24, 2006. Levaquin (Livofloxacin) was received for six days on February 27, 2012, both courses several years before 2011, Table 1. Figure 1. Case 1 – Right Internal Iliac Aneurysm On August 31, 2016 an 86 years old man was admitted complaining of acute generalized abdominal pains of 18 hours duration. In the afternoon of the previous day, he suffered upper abdominal pains with vomiting and repeated eructations. No point tenderness was present. He was afebrile. Complete metabolic panel was normal with normal hemogram. Immediate computed tomography (CT scan) revealed a 1.5 x 2 centimeter mesenteric aneurysm, possibly ruptured, Figure 2, as well as two smaller aneurysms a few millimeters each in diameter and abdominal aortic and carotid dilatation. A few small galls stones were seen. Immediate percutaneous embolization of the large aneurysm was performed two days before the procedure and six days afterward he received Levaquin. Follow up CT scan of the abdomen 18 months later showed the embolized mesenteric aneurysm and no change in the smaller ones. The symptoms have not recurred two years later. Figure 2. Case 2 – Superior Mesenteric Artery Branch Aneurysm. A 66 year old man was admitted to Christ Hospital in Jersey City, New Jersey, complaining of abdominal and back pain and weakness of at least one month duration. He had lost 40lbs of