2019 Volume 31 Issue 2 Pages 53-56
Simultaneous onset of ruptured intracranial and intra-abdominal aneurysms are rare. We report the case of a patient who suffered from a subarachnoid hemorrhage (SAH), coexisting intra-abdominal hematoma. A 51-year-old man was transferred from another hospital for consciousness disturbance with hemodynamic instability. The contrast computed tomography (CT) showed SAH caused by the left ruptured vertebral artery dissecting aneurysm and intraabdominal hematoma caused by the ruptured posterior superior pancreaticoduodenal artery aneurysm. On CT examination of abdomen with contrast, another finding of the compression of celiac artery by midline arcuate ligament in were revealed. He was diagnosised with median arcuate ligament syndrome. Transcatheter arterial embolization (TAE) of the ruptured posterior superior pancreaticoduodenal artery was first attempted to control the bleeding. After successful of abdominal hemostasis was achieved by TAE, a coil embolization with stent combination was performed for the left ruptured vertebral artery dissecting aneurysm. He was transferred to a rehabilitation hospital at modified rankin scale 1 after treatment. We should be considered the possible of the coexisting of intra-abdominal hematoma for severe SAH with hemodynamic instability.