A case of a ruptured left gastroepiploic artery aneurysm, diagnosed on mdct angiography and treated by transcatheter arterial embolization

Abstract

A 51-year-old man complained of upper abdominal pain. There was no rebound tenderness or abdominal muscle guarding. Bloody ascites was seen on plain abdominal CT scan. Enhanced multidetector CT (MDCT) showed an aneurysm, 9 mm in diameter involving the left gastroepiploic artery (LGEA). An intra-abdominal hemmorage caused by rupture of the LGEA aneurysm was diagnosed. Angiography to make a definite diagnosis and for transcatheter arterial embolization (TAE) was performed. We successfully embolized the artery proximally and distally to the aneurysm. After embolization, the patient had no abdominal symptoms ; his anemia did not progress. The aneurysm was no longer detected on enhanced CT. Two months later, enhanced CT showed the aneurysm filled with organized thrombus.
There are only a few reports of a ruptured aneurysm diagnosed on MDCT and treated using transcatheter arterial embolization (TAE) without resorting to surgery. We report this case and review the relevant literature.