Aortomesenteric bypass using autogenous saphenous vein graft for superior mensenteric artery aneurysm: report of a case.

We report a 62-year-old man who had symptoms of abdominal angina and was diagnosed preoperatively with a superior mesenteric artery (SMA) aneurysm. The findings of the CT scan and angiography revealed a 3 X 4 cm saccular aneurysm at the proximal site of the SMA. During abdominal exploration, a weak pulsation of the SMA branches distal to the aneurysm was felt. The aneurysmal cavity was full of old thrombi. Brisk retrograde bleeding from the orifices of the connecting collaterals was seen after removal of the thrombi. Our operative procedures included endoaneurysmorrhaphy, proximal ligation, and distal interruption of the aneurysm. Vascular reconstruction by an aortomesenteric bypass using a segment of autogenous saphenous vein graft was also done. After creating the vein graft bypass, the weak pulsation of the distal SMA branches became normalized. The patient enjoyed an uneventful postoperative course and did not complain of abdominal pain on clinical follow up. Four months later, he received an evaluation including angiography and CT scan, which confirmed that the vein graft was patent and without deformity.