Enlarging Superior Mesenteric Artery Aneurysm Successfully Treated By Selective Angiography And Embolization With Terumo Hydrocoil: A Case Report And Review Of The Literature

“Background” Aneurysms and pseudo-aneurysms of the superior mesenteric artery are rare and potentially lethal. Such aneurysms may be found incidentally or they may be diagnosed after complications have occurred. “Aims” To report a case of Superior Mesenteric Artery Aneurysm, diagnosed incidentally, and successfully treated by Selective Angiography and Embolization To review the literature on Superior Mesenteric Artery aneurysms “Case Report” A lady who has been followed up for hepatitis C and cirrhosis of liver had MRI scan of the abdomen which showed a 1.9 cm lesion in her liver which was consistent with hepato-cellular carcinoma. She had previously had ultrasound scan of her liver and liver biopsy which confirmed cirrhosis of liver and no evidence of malignancy. She successfully underwent 3 sections of selective angiography and embolization of the hepatocellular carcinoma with disappearance of the tumour. During the process of the embolization of the hepato-cellular carcinoma the patient’s previous MRI scans and CT scans were reviewed and these revealed that the patient had a Superior Mesenteric Artery Aneurysm which had enlarged over a period of 3 years. Selective Superior Mesenteric Artery Angiography and embolization of the aneurysm was successfully carried out using Terumo hydro-coil. Literature review revealed that cases of Superior Mesenteric Artery Aneurysms are rare and they have been treated traditionally by means of open surgery however, some cases of Superior Mesenteric Artery Aneurysms have been treated recently by embolization but coil migration has been reported. Conclusions: With developments in interventional radiology and coil technology selective superior mesenteric artery angiography and embolization of superior mesenteric artery aneurysm has become a safe alternative modality of treatment instead of open surgery. This technique has the added advantage of: avoiding general anaesthesia and laparotomy; being less invasive; being associated with low morbidity; short period of hospitalization. The Terumo hydrocoil which is now available for such embolizations has the added advantage of expanding to fill up the aneurismal cavity up to 5.8 times more than conventional coils and it does not dislodge easily.