Surgical treatment of a giant aneurysm of the superior mesenteric artery in a patient with systemic lupus erythematosus

Visceral artery aneurysms (VAAs) are rare, representing ˂2% of all arterial aneurysms in adults, with superior mesenteric artery aneurysms (SMAAs) being the third most common type. Systemic lupus erythematosus (SLE) is associated with vascular complications, including vasculitis and antiphospholipid syndrome, which may contribute to aneurysm formation. However, SMAAs in SLE patients are seldom reported. A 45-year-old male patient with SLE and chronic abdominal pain was presented to our clinic. Imaging revealed a 56-mm SMAA with thrombosis and stenosis. Due to rupture risk, open surgical repair was performed using a reversed saphenous vein graft, successfully revascularizing four mesenteric branches. Recovery was uneventful. Although endovascular techniques are less invasive, open surgical repair remains the preferred approach for complex aneurysms involving multiple branches. This case underscores the role of SLE-related vasculitis in aneurysm formation and highlights the need for early diagnosis and intervention.