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Case 80

Mycotic aneurysm of the SMA

A man with abdominal pain

Dr Avi Saks

This patient presented with bacterial endocarditis, for which he had just begun antibiotic treatment. He also complained of abdominal pain, and an intravenous contrast enhanced CT of the abdomen was obtained.

Findings

The two sample CT images demonstrate absence of contrast within the superior mesenteric artery. The artery is enlarged and contains low attenuation thrombus. Given the known history of bacterial endocarditis, the likely diagnosis is of a mycotic aneurysm.

Diagnosis

Mycotic aneurysm of the SMA

Discussion

The patient was treated with appropriate antibiotics and the aneurysm resolved, as demonstrated on sequential ultrasound scans (not shown).

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