Celiomesenteric Trunk Compression and Absence of Collateral Vessels in the Large Intestine

The authors report the case of a rare mesenteric anomaly in a 71-year-old man who presented with a preexisting abdominal aortic aneurysm (AAA) and a progressive history of postprandial abdominal pain and 10-lb weight loss. Aortography revealed a common celiomesenteric trunk, an absent middle colic artery, and a stenotic inferior mesenteric artery. At operation, neural fibers compressing the common celiomesenteric trunk were lysed, the AAA was repaired, and the inferior mesenteric artery was subjected to endarterectomy and then reimplanted. The patient remains well and free of symptoms 1 year after operation. This rare case demonstrates the many different causes of intestinal angina and its surgical relief.