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Abstract
Background :
Aneurysm of the superior mesenteric artery is a serious condition that is diagnosed in case of a complication such as rupture or digestive ischemia. The aim of this study was to report on the management of a case of ruptured superior mesenteric artery aneurysm at the Maradi Reference Hospital in Niger.
Case presentation :
S.S., 12 years old child, referred from Maradi Regional’s Hospital for acute abdominal pain, which had been evolving for seven days. Medical records reveal a background of ventricular septal defect with moderate mitral insufficiency. On admission, there was hemodynamic instability with pulse at 140, tachypnea at 28 cycles with pallor. Examination revealed abdominal distension with a periumbilical mass, severe anemia. Ultrasonography found an intraperitoneal collection suggesting a ruptured aneurysm. A subsequent abdominal CT scan shows a contained rupture of an aneurysm in the end portion of the superior mesenteric artery. The preoperative cardiac evaluation found vegetations at the mitral level and on the defect, suggesting a mycotic origin. After blood transfusion, emergency laparotomy was performed which consist in controlling the superior mesenteric artery at its origin, then aneurysm was excluded. At the end, the distal small bowel showed good recoloration. The child was transferred to cardiology unit for further management.
Conclusion :
Rupture of an SMA aneurysm is a real challenge requiring a multidisciplinary approach. The risk of intestinal ischemia must be considered. Revascularization may be useful except in cases of terminal SMA disease.
References
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Copyright (c) 2026 M Abdoulaye, M Mamane, A Ousseini, I Amadou Magagi, A Baragé, M Hamissou, R Miri, A Saidou, H Adamou, L James Didier, R Rachid