Case 105: Left Gastric Artery Aneurysm

Pivawer, Gabriel; Lee, Jay L.; Nardi, Peter M.

doi:10.1148/radiol.2421032008

Cited by 7 publications

(8 citation statements)

References 3 publications

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“…They most frequently develop secondary to an adjacent inflammatory process. 6 Other causes include medial degeneration, arteriosclerosis, trauma, arteritis, fibromuscular dysplasia, and connective tissue disorders. Also, mycotic visceral artery aneurysms as a result of infected thrombo-emboli or seeding of an existing aneurysm have been reported.…”

Section: Discussionmentioning

confidence: 99%

“…Also, mycotic visceral artery aneurysms as a result of infected thrombo-emboli or seeding of an existing aneurysm have been reported. 6 …”

Section: Discussionmentioning

confidence: 99%

“…Patients with visceral artery aneurysms are often asymptomatic and the diagnosis is incidental. However, some patients may present with vague abdominal discomfort or life threatening bleeding because of rupture into the gastrointestinal tract or the peritoneal cavity, 6 which is associated with morbidity and mortality 7 (as high as 70% 2 ). Any GAA discovered before rupture should, therefore, be repaired.…”

Section: Discussionmentioning

confidence: 99%

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Posterior Gastric Artery Aneurysm

Gomes

Lopes

Sobrinho

et al. 2018

EJVES Short Reports

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IntroductionAneurysms of small abdominal vessels are extremely rare; however, even minor aneurysmal accessory arteries can rupture, leading to potentially fatal consequences. The purpose of this paper is to report a case of coil embolisation of an aneurysmal posterior gastric artery.Case presentationThe authors describe the case of a 66 year old female patient with an aneurysm of the posterior gastric artery. Coil embolisation was performed. The six month follow up computed tomography angiogram revealed exclusion of the aneurysm.DiscussionThe presented case is exceedingly rare. This type of aneurysm has to be kept in mind as a possible cause of bleeding, despite the limited information regarding their natural history.ConclusionOwing to the safety and applicability of the endovascular technique, it is nowadays probably the best treatment alternative for this type of aneurysm.

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Section: Discussionmentioning

confidence: 99%

“…Also, mycotic visceral artery aneurysms as a result of infected thrombo-emboli or seeding of an existing aneurysm have been reported. 6 …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Posterior Gastric Artery Aneurysm

Gomes

Lopes

Sobrinho

et al. 2018

EJVES Short Reports

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“…The left gastric artery aneurysm (LGAA) are even more infrequent, with an incidence of less than 4% of all VAA. 6 As a result, there is a paucity of literature on the treatment of LGAA, most of which describe radiologic or endovascular embolization. 7,8 To date, there have been no reported cases of successful ligation and resection of LGAA when performed using a laparoscopic approach.…”

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confidence: 99%

Laparoscopic Left Gastric Artery Aneurysm Resection

et al. 2016

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Aneurysmal degeneration of the visceral branches of the abdominal aorta is a rare and potentially life-threatening disease entity 1,2 with a documented prevalence of 0.1 to 2%. 3,4 Visceral artery aneurysms (VAAs) most often involve the splenic, hepatic, celiac, and superior mesenteric vessels. Collectively, these splanchnic aneurysms frequently rupture, with an associated high mortality rate. Shanley et al 5 reviewed cases of VAA from 1985 to 1995, reporting a mortality rate of 21% for ruptured hepatic artery aneurysms and 100% for ruptured celiac artery aneurysms. The left gastric artery aneurysm (LGAA) are even more infrequent, with an incidence of less than 4% of all VAA. 6 As a result, there is a paucity of literature on the treatment of LGAA, most of which describe radiologic or endovascular embolization. 7,8 To date, there have been no reported cases of successful ligation and resection of LGAA when performed using a laparoscopic approach. Case ReportA 68-year-old man was referred for treatment of a known 2 cm LGAA. Medical and surgical history were significant for atrial flutter, hypercholesterolemia, and duodenal ulcer requiring endoscopic cauterization. The patient had developed epigastric and back pain which had prompted a work-up including computed tomographic (CT) imaging with intravenous contrast (►Figs. 1 and 2) revealing LGAA. At that time, the patient did not have abdominal tenderness or a pulsatile mass on examination.The patient underwent hematologic work-up to rule out polyarteritis nodosum and collagen vascular diseases. The cytoplasmic antineutrophil cytoplasmic antibodies and perinuclear antineutrophil cytoplasmic antibodies were not present in the blood. The C3 and C4 levels were found to be normal. His antinuclear antibody (ANA) level was within normal limits. Surgical treatments were discussed with the patient, including percutaneous embolization, laparoscopic and open ligation, as well as the option for conservative management. The patient opted for surgical resection of the aneurysm, feeling it would be the most definitive treatment.The anatomy showing the LGAA was preoperatively delineated after reviewing the CT scan. A supraumbilical Veress needle, Step TM insufflation/access needle (Medtronic, Minneapolis, MN), was employed to establish pneumoperitoneum. A 10-mm flexible tip laparoscope was placed in the paraumbilical region for visualization. The flexible liver retractor was positioned through a right upper quadrant 5 mm trocar to provide upward retraction onto the left lateral segment of the liver. The operating surgeon worked through AbstractAneurysmal degeneration of the visceral branches of the abdominal aorta is a rare and potentially life-threatening disease entity. Visceral artery aneurysms (VAAs) are exceedingly rare and have a prevalence of 0.1 to 2%. The left gastric artery aneurysm (LGAA) is even more rare and accounts for less than 4% of all VAAs. There is scarce literature on treatment of LGAA by embolization; however, to date successful laparoscopic repair of an LGAA...

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“…They occur most commonly in the splenic artery (60 %) [2]. Left gastric artery aneurysms are extremely rare [3]. Multiple aneurysms are present in approximately a third of patients [4].…”

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confidence: 99%