Direct Superior Mesenteric Artery fenestration for Type B dissection with visceral ischemia

摘要

We describe a successful case of direct superior mesenteric artery fenestration for an acute type B dissection complicated by bowel necrosis. A 68 year-old man diagnosed with a type B dissection suffered from abdominal pain. At 11 days after the onset, CT scan showed a superior mesenteric artery obstruction. Cecal necrosis was detected during an emergency laparotomy. We fenestrated and connected the true lumen with the false lumen of the superior mesenteric artery, and performed a thrombectomy for both lumens. Immediately, thereafter, a bowel resection was performed. He required intensive care postoperatively, but was discharged uneventfully after recovery.