# Severe Chronic Mesenteric Ischemia in a Patient with Moyamoya Disease

## TL;DR

A patient with moyamoya disease developed severe chronic mesenteric ischemia and was successfully treated with a bypass surgery.

## Contribution

This case report highlights the rare occurrence of mesenteric ischemia in moyamoya disease and its successful surgical management.

## Key findings

- A 35-year-old woman with moyamoya disease presented with chronic mesenteric ischemia.
- A bypass surgery using a saphenous vein graft resolved her symptoms successfully.
- The case suggests that mesenteric arterial lesions can develop in moyamoya disease patients.

## Abstract

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.