Successful coil embolization of ruptured middle colic artery aneurysm: a case report

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We describe a case in which transcatheter arterial embolization (TAE) for a ruptured middle colic artery aneurysm (MCA-A) was successfully performed. A 51-year-old woman with a history of alcoholic liver dysfunction was transferred to our hospital with severe abdominal pain, diarrhea, and vomiting that had developed one week before admission. On arrival, the patient was pale, and showed significant peripheral coldness, tachycardia, and abdominal distension. The white blood cell count was 11,700/mm³ and the hematocrit value was 15.1%. Abdominal computed tomography (CT) with contrast enhancement revealed an aneurysm in the MCA and marked fluid collection. With a diagnosis of ruptured MCA-A, TAE was emergently performed. Arteriography of the superior mesenteric artery demonstrated an aneurysm of 8 mm in diameter in the MCA. TAE was successfully performed. Persistent fever occurred from the 18th hospital day, and a remaining intramesocolic hematoma detected on follow-up CT was thought to be its cause. Drainage was performed on the 23rd hospital day. The patient was subsequently discharged on the 39th hospital day. In conclusion, detailed CT examination is helpful for a diagnosis of MCA-A, and TAE is effective in the treatment of a ruptured MCA-A.