RUPTURED MESENTERIC-ARTERY ANEURYSM IN A PATIENT WITH ALPHA1-ANTITRYPSIN DEFICIENCY - ETIOLOGIC IMPLICATIONS

Clinical observations suggest that some aneurysms may be manifestations of intrinsic tissue abnormalities or systemic discase. Several investigators have reported reduced elastin content and increased elastase activity in infrarenal aortic aneurysms. Alpha1-antitrypsin is the primary serum protease inhibitor modulating elastase activity. Elevated elastase activity caused by reduced alpha1-antitrypsin inhibition, theoretically, could contribute to aneurysm formation. We report a case of ruptured middle colic artery aneurysm in a patient with multiply visceral artery aneurysms and profound alpha1-antitrypsin deficiency. Reported middle colic artery aneurysms arc reviewed, and etiologic implications are discussed.