A Case of Ruptured Middle Colic Arterial Aneurysm Resulting in a Large Intra–Abdominal Mass

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We report a patient with a ruptured middle colic artery aneurysm who underwent emergency surgery. The patient was a 47–year–old woman who visited our hospital with a chief complaint of abdominal pain. She developed shock during examination, and was immediately admitted to the ICU. On admission, plain abdominal CT demonstrated a large mass in the left upper abdominal cavity. On the third day after admission, the Hb level dropped rapidly. Emergency contrast–enhanced CT revealed rupture of the middle colic artery aneurysm ; therefore, emergency surgery, including hematoma removal, aneurysm resection, and partial transverse colectomy, was performed. Pathological examination of the aneurysm showed segmented arterial mediolysis (SAM).