A Case of Gastric Cancer with a Ruptured Right Gastroepiploic Aneurysm

Abstract

A 64-year-old woman who had been dizzy for two months was rushed to our hospital due to vomiting and hematemesis. Upper endoscopy on admission showed scirrhous gastric cancer and an exposed aneurysm at the base of the ulcer. Abdominal contrast-enhanced computed tomography showed thickening of the gastric wall and an exposed, 7.5-mm, right gastroepiploic aneurysm in the stomach. Three days after admission, she developed hemorrhagic shock after vomiting a large amount of blood, and she underwent emergency surgery. At the time of laparotomy, there was no intraperitoneal bleeding ; all bleeding was limited to within the gastrointestinal tract. Therefore, she was diagnosed as having a ruptured right gastroepiploic aneurysm. After ligating the inflow and outflow vessel of the aneurysms, distal gastrectomy was performed. The resected specimen showed a ruptured vessel wall at the base of the gastric cancer ulcer. After discharge from the hospital on the 15th postoperative day she underwent chemotherapy, but she died of gastric cancer 11 months after the operation. Although patients with a right gastroepiploic aneurysm that ruptures in the gastrointestinal tract are extremely rare, such rupture can easily lead to shock ; therefore, prompt diagnosis and treatment are needed.