Ruptured and Unruptured Mycotic Superior Mesenteric Artery Aneurysms

Aneurysms of the superior mesenteric artery (SMA) and branches thereof are uncommon but have a high rate of rupture and mortality relative to other visceral artery aneurysms. Historically, the predominant etiology has been infectious; with a renewed rise in intravenous drug abuse rates in the last decade, we hypothesize a resurgence in septic embolic complications may occur in the coming years. Here, we describe the presentation and management of 2 cases of intravenous drug users presenting with infectious endocarditis and SMA main trunk and branch aneurysms, one of which was ruptured. In addition, we review the literature on these rare clinical entities.