ArticleEJVES vascular forum2025
Idiopathic Inflammatory Superior Mesenteric Artery Aneurysm: Case Report and Systematic Literature Review.
Article in EJVES vascular forum, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Superior mesenteric artery aneurysm (SMAA) is a rare presentation mostly secondary to atherosclerosis, infection, cystic medial dysplasia, collagen vascular disorders, trauma, and arterial dissection. However, inflammatory SMAAs are sometimes idiopathic. The aim of the article is to report the case of an idiopathic inflammatory SMAA and perform a systematic literature review. Case report: A 61 year old man presented with chronic abdominal pain. Computed tomography angiography showed a typical 65 mm diameter inflammatory abdominal aortic aneurysm and a SMAA with similar signs of wall inflammation. Positron emission tomography computed tomography confirmed the inflammation by active fixation. A full workup including all inflammatory markers was negative, and no cause was found. Treatment consisted of fenestrated endograft implantation. At 11 months, follow up confirmed aneurysm exclusion and patency of the stents and a similar SMAA diameter with some mild remaining inflammation. Literature review: A systematic review of the MEDLINE and PubMed databases extending from 1979 to 2024 by a combined strategy of Medical Subject Headings terms returned only two publications of idiopathic inflammatory SMAA in two patients. In both cases, the symptoms were abdominal or lower back pain and the diagnosis was made by computed tomography angiography. Treatment was open surgery in one case and medical in the other. Median follow up was 18 months. Conclusion: Idiopathic inflammatory SMAA is rarely described in the literature. The aetiological assessment including histological data should be exhaustive in order not to miss a differential diagnosis.
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