Segmental arterial mediolysis with mesenteric haemorrhage

Case contributed by Dr Thomas Snow

Presentation

Sudden abdominal pain 10 days after uneventful endovascular AAA repair.

Patient Data

Age: 75
Gender: Male

CT aortogram shows two mesenteric vessel aneurysms within in a mesenteric haematoma. 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 catheterisation 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

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 ischaemia was detected.

Case Discussion

Case of segmental arterial mediolysis presenting with spontaneous mesenteric haemorrhage. Large middle colic aneurysm found angiographically and treated with coils deployed proximal and distal to the aneurysm. 

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Case information

rID: 30332
Case created: 3rd Aug 2014
Last edited: 27th Sep 2015
System: Vascular
Inclusion in quiz mode: Included

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