A Challenging Case of Fibromuscular Dysplasia in a Transgender Patient: Is There a Hormonal Link?

摘要

Introduction Fibromuscular dysplasia (FMD) and superior mesenteric artery (SMA) aneurysms are rare vascular conditions. An unusual combination of both diseases is reported. Case report A 54 year old woman presented with symptomatic SMA aneurysm. A diagnosis of FMD was made on the basis of computed tomography angiography (CTA). The patient had undergone gender reassignment surgery 10 years previously and continued to use both topical and oral hormonal therapy. The patient received open anatomical bypass through a retroperitoneal approach using great saphenous vein. Conclusion Superior mesenteric artery aneurysms are rare and a diagnosis of FMD should be considered as part of the diagnosis process. Anatomical bypass should be considered carefully in relation to a patient's fitness as well as anatomical suitability. Highlights ? Urgent repair of a symptomatic mesenteric aneurysm is recommended by the ESVS guidelines. ? Fibromuscular dysplasia could be the underlying pathology for mesenteric aneurysm. ? Retroperitoneal exposure gives access for anatomical repair of the superior mesenteric artery aneurysm.