1998 Volume 59 Issue 5 Pages 1286-1289
A 67-year-old man who was staying in the hospital for treatment of bronchial asthma and chronic pulmonary emphysema abruptly developed an abdominal pain and fell into a shock state. Laboratory date indicated anemia. Abdominal CT carried out with a diagnosis of hypovolemic shock revealed extravasation of a contrast medium to the peritoneal cavity. We suspected bleeding from the liver parenchyma, and carried out an abdominal angiography. Angiography revealed three aneurysms of the right gastric artery and one of them was ruptured. TAE was performed successfully, but re-bleeding from the aneurysms was noted an hour later.
Emergency laparotomy showed hemoperitoneum due to.the ruptured aneurysm of hte right gastric artery. The aneurysms with right gastric artery about 3cm in length were resected. In postoperative course, hemostasis was completely attained, but the patient died of respiratory failure on 46 postoperative day.
Twenty-four cases of ruptured gastric artery aneurysm have been reported in Japan, and most of the patients underwent surgery. Though none of these patients were successfully treated with TAE alone, abdominal angiography or TAE should be performed first, if the patient is in poor condition.
Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)
