主要な腹部臓器血流をmeandering mesenteric arteryから供給された腹部大動脈瘤の1手術例

A 64 year old man underwent hemodialysis one year ago was detected an infra renal abdominal aortic aneurysm with the occluded lesion of the superior mesenteric（SMA）and the celiac arteries. Abdominal angiogrphy revealed that the branches of the SMA filled reversely from the inferior mesenteric artery through the large meandering mesenteric artery（MMA）. Therefore it was thought that a prolonged clamping time during the aortic reconstruction would possibly result in visceral ischemic injury, the MMA was perfused by an extracorporeal circulation system during the aortic cross-clamping. The postoperative course was uneventful, without visceral ischemic complication. Consequently ischemic enterocolitis is a serious complication and a factor of poor prognosis in an operation of abdominal aortic aneurysm, it is important that understood the state of the visceral circulation and decided the strategy of the operation with or without the branches repaired for preventing ischemia.

四国医学雑誌 : http://www.med.tokushima-u.ac.jp/article/0012780.html