We report a case of a large aneurysm of the inferior mesenteric artery that extended from its origin to bifurcation in the left colic and sigmoidal arteries, and was associated with occlusion of the celiac and superior mesenteric arteries in a 64-year-old patient. The diagnosis was made by arteriography. The patient underwent angioplasty and stenting of the superior mesenteric artery before the operation, which consisted of resection of the aneurysm and reimplantation of the left colic and the sigmoidal arteries separately in the aorta. We believe that this is the first reported case managed by angioplasty in combination with surgery, as well as reimplantation of the branches of the inferior mesenteric artery.