Presentation
Sudden abdominal pain 10 days after uneventful endovascular AAA repair.
Patient Data
CT aortogram shows two mesenteric vessel aneurysms within in a mesenteric hematoma. The largest aneursym is within the middle colic artery. CTA also showed string-of-beads sign in the left colic arterial arcade (not pictured).
Digital subtraction image showing triple coaxial system for selective catheterization of the middle colic artery. 6French guide catheter (Cook, Bloomington, Illinois, USA), Van Schie 3 5Fr catheter (Cook), 2.7 Fr Progreat micro catheter (Terumo, Japan).
CT aortogram one month later
CT follow up aortogram one month later. Sagittal maximum intensity projection, shows exclusion of the middle colic artery aneurysm by coils deployed proximal and distal to the aneurysm. No colonic ischemia was detected.
Case Discussion
Case of segmental arterial mediolysis presenting with spontaneous mesenteric hemorrhage. Large middle colic aneurysm found angiographically and treated with coils deployed proximal and distal to the aneurysm.
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