Pseudoaneurisma roto de artéria ileocólica: relato de caso
Ruptured ileocolic artery pseudoaneurysm: case report
Carolina Vasconcellos Sant’Anna; Felipe Garcia Kuhl; Alane Miranda Leite; Selma Regina de Oliveira Raymundo; André Rodrigo Miquelin; Vitória Acar; Vitor Brumato Fachini; Matheus Rafael Canuti
Visceral artery aneurysms (VAAs) and visceral artery pseudoaneurysms (VAPAs) are rare conditions and are potentially lethal when they rupture. They are usually found as incidental findings on computed tomography (CT) scans of asymptomatic patients. Although conventional open surgery is currently considered the gold standard treatment, the endovascular approach has gained prominence as a minimally invasive procedure with lower surgical risk. In this approach, use of coil embolization in saccular VAAs and VAPAs and implantation of flow-modulating stents constitute alternative treatments for fusiform aneurysms. We present the case of a 51-year-old female patient complaining of acute abdominal pain, tachycardia, and hypotension, with evidence of abdominal bleeding on CT angiography, who was diagnosed with a ruptured ileocolic artery (ICA) pseudoaneurysm. She underwent early endovascular treatment for ICA embolization, which was successful and achieved clinical improvement
1 Chiesa R, Astore D, Guzzo G, et al. Visceral artery aneurysms. Ann Vasc Surg. 2005;19(1):42-8.
2 Moraes D Fo, Trevisan FB, Silvestre JMS, et al. Vascular ultrasonography for follow-up of endovascular repair of abdominal aorta aneurysms. J Vasc Bras. 2014;13(3):168-74.
3 Azevedo FC, Zerati AE, Blasbalg R, Wolosker N, Puech-Leão P. Comparison of ultrasonography, computed tomography, and magnetic resonance imaging with intraoperative measurements in the evaluation of abdominal aortic aneurysms. Clinics (São Paulo). 2005;60(1):21-8.
4 Sueyoshi E, Sakamoto I, Nakashima K, Minami K, Hayashi K. Visceral and peripheral arterial pseudoaneurysms. AJR Am J Roentgenol. 2005;185(3):741-9.
5 Pulli R, Dorigo W, Troisi N, Pratesi G, Innocenti AA, Pratesi C. Surgical treatment of visceral artery aneurysms: a 25-year experience. J Vasc Surg. 2008;48(2):334-42.
6 Jesinger RA, Thoreson AA, Lamba R. Abdominal and pelvic aneurysms and pseudoaneurysms: imaging review with clinical, radiologic, and treatment correlation. Radiographics. 2013;33(3):E71-96.
7 Roche-Nagle G, O’Donnell D, O’Hanrahan T. Visceral artery aneurysms: a symptomatic aneurysm of the ileocolic artery. Vascular. 2007;15(3):162-6.
8 De Rosa A, Gomez D, Pollock JG, et al. The radiological management of pseudoaneurysms complicating pancreatitis. JOP. 2012;13(6):660-6. PMid:23183395.
9 Taboada CR, Alonso JG, Cortés RP, Pelayo LV, Hernández PV, Sánchez FS. Dual endovascular repair (coils and stent) of a true aneurysm of the gastroduodenal artery. J Vasc Bras. 2020;19:e20190123.
10 Shawky MS, Tan J, French R. Gastroduodenal Artery aneurysm: a case report and concise review of literature. Ann Vasc Dis. 2015;8(4):331-3.
11 Saran M, Biswas S. A rare case of jejunal pseudoaneurysm presenting as acute small bowel obstruction after blunt trauma: discussion, management dilemmas, and a review of relevant literature. Cureus. 2019;11(9):e5655.
12 Tulsyan N, Kashyap VS, Greenberg RK, et al. The endovascular management of visceral artery aneurysms and pseudoaneurysms. J Vasc Surg. 2007;45(2):276-83, discussion 283.
13 Pitton MB, Dappa E, Jungmann F, et al. Visceral artery aneurysms: Incidence, management, and outcome analysis in a tertiary care center over one decade. Eur Radiol. 2015;25(7):2004-14.
14 Ikeda O, Tamura Y, Nakasone Y, Iryou Y, Yamashita Y. Nonoperative management of unruptured visceral artery aneurysms: treatment by transcatheter coil embolization. J Vasc Surg. 2008;47(6):1212-9.
15 Santos FS, Sousa KMDS, de Castro TAC, et al. Endovascular treatment of pseudoaneurysms secondary to chronic pancreatitis: reports of two cases. J Vasc Bras. 2018;17(1):71-5.
16 Cely C, Stollman NH. Lupus abdominal crisis owing to rupture of an ileocolic aneurysm with successful angiographic treatment. J Clin Gastroenterol. 2001;32(4):347-50.
17 Gabelmann A, Görich J, Merkle EM. Endovascular treatment of visceral artery aneurysms. J Endovasc Ther. 2002;9(1):38-47.
18 Saad NE, Saad WE, Davies MG, Waldman DL, Fultz PJ, Rubens DJ. Pseudoaneurysms and the role of minimally invasive techniques in their management. Radiographics. 2005;25(Suppl 1):S173-89.