Severe Chronic Mesenteric Ischemia in a Patient with Moyamoya Disease

Moyamoya disease is a rare cerebrovascular occlusive disorder, and its natural course remains incompletely understood. Although rare, extracranial arterial lesions can develop in patients with moyamoya disease. We report the case of a 35-year-old Japanese woman with moyamoya disease who was referred to our department for the treatment of severe chronic mesenteric ischemia. She had a several-year history of postprandial abdominal pain and experienced two episodes of gastric ulcer perforation in the past year. Enhanced computed tomography revealed that the patient had a common trunk of the celiac and superior mesenteric arteries, which was occluded at its origin. The patient underwent an aorta to superior mesenteric artery bypass with a great saphenous vein graft. The postoperative period was uneventful, and the patient is now free of symptoms. The present case suggests that a patient with moyamoya disease can develop symptomatic mesenteric arterial lesions.