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KMID : 0604020150300040354
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Korean Journal of Critical Care Medicine
2015 Volume.30 No. 4 p.354 ~ p.357
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Endovascular Treatment of Proximal Superior Mesenteric Artery Pseudoaneurysm after Stab Injury
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Kim Dong-Hun
Kim Young-Wook
Park Kwang-Bo
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Abstract
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Superior mesenteric artery (SMA) injuries remain a challenge to most trauma surgeons and continue to result in significant mortality despite aggressive management. We report successful management of a proximal SMA injury through endovascular treatment in a 56-year-old man. The patient presented with hypotension due to a stab wound after the epigastrium. He underwent emergency laparotomy and repair of the penetrated wall of the stomach. Right retroperitoneal hematoma at the initial laparotomy expanded and ruptured, requiring a massive transfusion. At the second laparotomy, we performed lateral arteriorrhaphy of the proximal SMA. Follow-up abdominal computed tomography angiography on post-injury day 7 showed a pseudoaneurysm on the left side of the SMA trunk. The patient was treated successfully with an endovascular stent graft.
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KEYWORD
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endovascular procedure, superior mesenteric artery, trauma
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