腹腔動脈と上腸間膜動脈の起始部閉塞に下腸間膜動脈瘤を伴った胸腹部大動脈瘤

摘要

A 56-year-old man with thoracoabdominal aortic aneurysm combined with inferior mesenteric artery aneurysm and occlusion of celiac and superior mesenteric arteries is presented.Contrast-enhanced computed tomography (CT) and aortography revealed thoracoabdominal aortic aneurysm of 6 cm in diameter,accompanied by inferior mesenteric aneurysm of 3 cm in diameter.Severe calcification of the abdominal aorta and occlusion of the celiac and the superior mesenteric arteries were also noted, whose territories were perfused by collateral circulation of the inferior mesenteric artery.At the operation, orifice of the left renal artery was stenosed by severe calcification, which was resected.Because of severe adhesion around the origins of celiac and superior mesenteric arteries, they were left unrevascularifeed The thoracoabdominal aortic aneurysm was replaced with an Dacron tube graft, whose side branch was anastomosed to the inferior mesenteric artery after resection of its aneurysm.The postoperative course was uneventful,and no symptoms of intestinal ischemia were noted. As blood supply to the abdominal viscera mostly depends on the inferior mesenteric artery, careful follow-up is necessary.