Four weeks following an aortic valve replacement for pneumococcal endocarditis, a 41-year-old man returned to the emergency room with vague abdominal pain. Initial evaluation included an abdominal CT scan, which demonstrated an abnormal vascular structure in the intestinal mesentery that was suspicious for an aneurysm.
Angiography confirmed an aneurysm in the distribution of the superior mesenteric artery. The aneurysm was located in an ileocolic branch. Note the aberrant right hepatic artery coming off the SMA (see biliary variation).
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