Abstract：
BACKGROUND: Aneurysms of the middle colic artery (MCAA) and its branches are exceedingly rare accounting for <3% of total visceral aneurysms. Very few MCAA cases have been reported in the literature with only three cases accounting for a diameter >4 cm.
METHODS: We describe the successful open repair with ligation of a 4.2 cm asymptomatic MCAA in a female patient through the gastrohepatic ligament taking meticulous caution to avoid injury of the pancreas. The postoperative period was uneventful and the patient was discharged from the hospital on the fifth postoperative day. At 1 month follow-up the postoperative computed tomographic angiography documented complete exclusion of the MCAA and absence of contrast agent in the sac both in the arterial and the venous phase.
CONCLUSIONS: While the endovascular treatment is the first-line option for visceral aneurysms, the open approach is still reserved for certain cases of hostile anatomy, challenging location and large size. Our case highlights the irreplaceable role of open surgery and underlines the collaboration between surgical specialties.
METHODS: We describe the successful open repair with ligation of a 4.2 cm asymptomatic MCAA in a female patient through the gastrohepatic ligament taking meticulous caution to avoid injury of the pancreas. The postoperative period was uneventful and the patient was discharged from the hospital on the fifth postoperative day. At 1 month follow-up the postoperative computed tomographic angiography documented complete exclusion of the MCAA and absence of contrast agent in the sac both in the arterial and the venous phase.
CONCLUSIONS: While the endovascular treatment is the first-line option for visceral aneurysms, the open approach is still reserved for certain cases of hostile anatomy, challenging location and large size. Our case highlights the irreplaceable role of open surgery and underlines the collaboration between surgical specialties.
摘要：
背景：中绞痛动脉（MCAA）及其分支的动脉瘤非常罕见，占总内脏动脉瘤的<3％。文献中报道的MCAA病例很少，只有3例直径>4厘米。
方法：我们描述了一名女性患者通过胃肝韧带结扎4.2cm无症状MCAA的成功开放修复，谨慎小心避免胰腺损伤。术后期间顺利，患者在术后第五天出院。在1个月的随访中，术后计算机断层扫描血管造影记录了MCAA的完全排除，并且在动脉和静脉阶段都没有造影剂。
结论：虽然血管内治疗是内脏动脉瘤的一线选择，开放方法仍然保留用于某些敌对解剖情况，具有挑战性的位置和大尺寸。我们的案例强调了开放手术的不可替代的作用，并强调了外科专业之间的合作。
方法：我们描述了一名女性患者通过胃肝韧带结扎4.2cm无症状MCAA的成功开放修复，谨慎小心避免胰腺损伤。术后期间顺利，患者在术后第五天出院。在1个月的随访中，术后计算机断层扫描血管造影记录了MCAA的完全排除，并且在动脉和静脉阶段都没有造影剂。
结论：虽然血管内治疗是内脏动脉瘤的一线选择，开放方法仍然保留用于某些敌对解剖情况，具有挑战性的位置和大尺寸。我们的案例强调了开放手术的不可替代的作用，并强调了外科专业之间的合作。
