Segmental arterial mediolysisによる左胃動脈瘤破裂の1例

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  • CASE REPORT OF RUPTURE OF A LEFT GASTRIC ARTERY ANEURYSM WITH SEGMENTAL ARTERIAL MEDIOLYSIS

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A 64-year-old man suffered from sudden discomfort and cold sweat. There was no change after 2 hours rest, so he was brought to the hospital by ambulance. His systolic blood pressure dropped to 70mmHg and he went into shock, with no response to catecholamine administration. A computed tomography scan revealed the presence of bloody ascites and aneurysma the left gastric arterial area. During emergency surgery, we noted about 3000ml blood in the abdominal cavity and a clot around an aneurysm of the left gastric artery. During the operation, we diagnosed the bleeding to be from an aneurysm of the left gastric artery, so the artery was resected. Histopathologically, the diagnosis was rupture of the arterial aneurysma due to segmental arterial mediolysis (SAM). The postoperative course was uneventful, and the patient was discharged on the 17th postoperative day.

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