Acute and Critical Care

Case Report

Vascular Surgery
Endovascular Treatment of Proximal Superior Mesenteric Artery Pseudoaneurysm after Stab Injury: Dong Hun Kim, Young-Wook Kim, Kwang Bo Park; Korean J Crit Care Med. 2015;30(4):354-357. Published online November 30, 2015; DOI: https://doi.org/10.4266/kjccm.2015.30.4.354

Abstract PDF: 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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